I am not an expert, but I would think a BM bx would allow the practitioner to evaluate other conditions such as myelofibrosis and the condition of your bone marrow. I would follow up with your oncologist/hematologist regarding this.

I guess it depends on the hematologist/oncologist’s experience. I was never offered the option - I requested it. It didn’t make a difference to treatment, but it did rule out advancing myelofibrosis.

Hi Jewelfaux, I think the answer about "does it make a difference to have diagnosis done via blood test or BMB" is "it depends". When I first saw my MPN specialist roughly a decade ago after high platelets and Jak2 mutation, I was told that based on blood work, ET was the probable diagnosis. My doctor advised that sometimes other MPNs (PV, MF) can present similar to ET in the bloodwork and the only way to truly diagnosis ET is via a BMB. Having said that, he also advised at that point, regardless of diagnosis, his treatment plan for me would be the same at that time (which was aspirin only).

I opted not to have a BMB at that time. As the years passed, I continued to ask about BMB, with generally the same response from my specialist. I did express concerns about potential progression, and he was clear that the BMB would be the best way to better understand this, as what can be uncovered in the blood work is much more limited than a BMB. I ultimately opted for the BMB, which showed that I had signs of both ET and pre-fibrotic MF, which to me was very important to know. Treatment has come a long way in the last decade, and as I understand it, interferons can be disease-modifying. So with the potential of MF on my horizon, I have been contemplating this course.

So the "it depends" answer is really: what is important for you to know about your ET/MPN? It is not "required" per se, but can be extremely valuable. I don't regret waiting to have one, but I am also glad I ultimately did. Knowledge is power.

Hugs to you my friend.

Laura