[Greg H]

Sandy,

Let me try to help with some other stuff about your brother's bone marrow report.

The bone marrow diagnosis is difficult to understand

No kidding! this is because it's a written in medical jargon.

Trilineage dysplasia with increased blasts, best characterized as refractory anemia with increased blasts -which means cells are abnormal in size/shape and immature?

You are right. "Dysplasia" means "messed up." "Tri-lineage" means in both the red cell line and white cell line, as well as the platelet line. So all three blood cell production lines are messed up. Plus he's got a bunch of blasts (immature white cells) hanging out in the bone marrow. Up to about five percent is considered normal, so he's not on the verge of converting to leukemia yet.

Dyserythropoiesis with megaloblastoid changes ?

Erythropoiesis is the red cell production mechanism. That's "dys" or "messed up." I wouldn't know a megaloblast if it kissed me, so I can't help there. But this is essentially a description of how the red cells production line is messed up.

Neutropenia with hypogranular neutrophils -low white cells?
Right again. There aren't enough mature neutrophils, but there are some messed up ones.

Myeloid left shift with increased blasts (7% by flow) -immature?
Yep. The "Myeloid" produciton line, which is the white cell production line, has too many immature white cells.

Megakaryocytic hypoplasia tih dysmegakaryopoiesis -low platelets?
Right again! The Platelet production line is not working right. I think "hypoplasia" means that there aren't enough megakaryocytes, which are the great big cells that platelets break off of.

Absence of iron stores

This suggests that there's not enough iron in the bone marrow to do a good job of producing blood, and there could be a variety of causes for that, including B12 and Folic Acid deficiencies.

If your brother hasn't been checked for those, they'll probably do that at the Cleveland clinic. They should check his copper and zinc, too.

You did a great job figuring out all that jargon. Pretty soon you'll be in demand around here to help people figure out their lab reports. Your brother is lucky to have you on his team.

There is a link between cigarette smoking and MDS, maybe because of the benzene in tobacco smoke. I have read of a link with alcohol abuse, but I have never found an actual scientific paper on that. My doc told me to quit drinking. I did, and lost 30 pounds, which was a good thing!

Let me and the other folks know if we can provide any additional help. There's a lot of experience amongst the denizens of marrowforums.

Take care!

Greg