Causes

Marrow infiltration by

• 2° malignancy: commonly breast, lung, prostate, thyroid, kidney, colon.

• Myelofibrosis (a primary myeloproliferative disorder, see p256).

• Other haematological malignancy e.g. myeloma and Hodgkin's disease.

• Rarely, severe haemolytic or megaloblastic anaemia.

Marrow stimulation by

• Infection, inflammation, hypoxia, trauma (common in ITU patients).

When due to marrow infiltration, there is often associated neutropenia

± thrombocytopenia. Marrow stimulative causes often have neutrophilia and thrombocytosis.

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