How to know if the increase in WBC is due to an infection or a neoplasm?

Hello doctor,

I need some follow-up information about a 77-year-old cousin diagnosed with JAK2 myeloproliferative and myelodysplastic neoplasm two years ago. He is being treated by a hematologist and gets consultation from his family physician. Unfortunately, he had several infections over the past year. I understand that his condition can progress into an acute transformation, although he is hematologically stable. We know that the CRP and white blood cell count are typically elevated when a person has an infection. But we have also been told that the CRP and WBC can be high when a person has an acute transformation. Is there any way in which a physician can reasonably differentiate between an acute transformation and an infection by analyzing blood tests even if the diagnosis cannot be proved?

Thanks.

Hello doctor,

Thanks for the reply.

I understand that an acute transformation is life-threatening. Is an overlap myeloproliferative or myelodysplastic neoplasm itself is a life-threatening diagnosis or is it concerning only when the overlap condition reaches a certain point?

Thanks.

Hello doctor,

Thank you again for your response.

He is taking tablet Hydroxyurea 500 mg once daily. However, he does not like the side effects of the medication and is talking about stopping it. I am pretty concerned about this. Is it possible for someone with his condition to very quickly and seriously deteriorate by suddenly stopping the medication?

Thanks.