Investigation and diagnosis

• Investigation as for MDS.

• Variable leucocytosis; marked in 50%; neutrophilia in some patients.

• Monocyte count >1.0 x 109/L is diagnostic minimum.

• Variable anaemia; platelets usually normal or decreased.

• Marrow typically hypercellular; blasts and promyelocytes <20%.

• Karyotypic abnormalities associated with MDS found in most patients but no specific cytogenetic features apart from rarity of 5q-.

• Lysozyme raised in serum and urine.

• Hypokalaemia may be present.

• Reactive causes of monocytosis must be excluded (fflp144).

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