70 year old male, having neutrophilic leucocytosis, ANC approx 20-25000/cmm along with hepatosplenomegaly for last 4 years. Bone marrow done at a different centre doesn’t show any blast, Neutrohilic abundance in BM. BCR-ABL negative , JAK V617F negative.
To find out causes of neutrophilia led us to SPEP- M Spike 3.2 gram/dl. IgA 3700mg/dl, IgM and IgG very low. The patient is also having hyperuricemia, mild KFT derangement.
Am I dealing with Plasma Cell disorder with secondary neutrophilic leucocytosis or two different entities separately?
How to proceed?