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So . . . my husband saw his new hematologist this morning. As is typically the case these days, platelets at 129 and RBC at 4.36 aren't much below their cut-off for normal. (His RBC and associated counts went up from about 3.6 at diagnosis once they started him on iron supplements, but now they have leveled off about where they were today. They never quite make it to the normal range.) But his ANC was at 704, so the neutropenia is still his main problem area. His lymphocytes were up to 1135, though; usually they hover around 600-700.
He asked about some of the terminology that often comes back in his labs: the resident told him that the occasional nucleated red blood cells and frequent large platelets are a sign that his bone marrow is under stress and is thus pushing out some blood cells a bit early. He had less to say about the other findings (Dohle bodies, toxic granulation, vacuolated neutrophils), except that they might be of prognostic significance in another setting but were not for my husband. Who knows. My husband didn't ask about hypo granular neutrophils since he has never had those. At any rate, at least for my husband, the large platelets don't seem to be anything to worry about in and of themselves, and I hope it's the same for you, Cheryl.
Next up: return in three months for labs unless he develops a fever. Possible second BMB if the ANC count continues on its downward trajectory. I also noticed requests for Serum Protein Electrophoresis and immunoglobulin tests and for copper as well as iron levels for next time. I was glad to see that, as I keep wondering if there might be some issue related to absorption since he has to take iron tablets every day just to keep his iron barely at low normal.
I'd rather he log in a few more neutrophils, but, all in all, it was a good report, enough to tide us over until early October.
Take care, everyone,
Barbara
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