He has a red blood count of 8.5 and white blood count of 200-500, his platelets are fine, spleen fine, no other symptoms. However, continues to be anemic. His doctor has recommended a bone marrow transplant. I really feel this diagnosis is extreme. However, the doctor keeps telling him that this is not the cause of the anemia.
Myelofibrosis is a difficult diagnosis to make.
Anemia is often a first sign. White blood cell count is often elevated. Platelet counts are either normal or elevated. The fact that your brother has a normal spleen and low white count is not consistent with the usual clinical syndrome. A second opinion from a hematologist is warranted before proceeding with aggressive treatment.