31st May 2023

A 70-year-old woman presents to her GP with persistent and progressive fatigue and weight loss over the last 4 months

A 70-year-old woman presents to her GP with persistent and progressive fatigue and weight loss over the last 4 months.

On examination, her spleen is palpable below the umbilicus.

Her GP arranges for urgent bloods:


Hb	72 g/L	(120-170 g/L)
WCC	13 x 10⁹/L	(3.6-11 x 10⁹/L)
Platelets	490 x 10⁹/L	(150-400 x 10⁹/L)
Blood film comment	Leukoerythroblastic film with tear-drop poikilocytes

What is the most likely diagnosis?

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