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Old Fri Oct 5, 2012, 12:23 AM
Hopeful Hopeful is offline
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Join Date: Jan 2009
Location: California, USA
Posts: 718
I will take a stab at the BMB report for you...

Bone Marrow Cytogenetic Report Bone Marrow Aspiration
Bone marrow aspiration taken from right PSIS
Specimen : Bone Marrow No fragents obtained
Collection Date : 10/01/12 Smear was hypocellular with occasional
myelocyte, neutrophil and normoblast seen

>> hypocellular means few cells. So your mom's marrow is emptier than expected for someone her age. This could mean that something is attacking her cells (as seen with aplastic anemia and some forms of MDS) or that there is something wrong with her ability to make blood cells (as seen with MDS, deficiencies, and other conditions).

Clinical Diagnosis : Myelodysplastic Syndrome No blast noted

>> No blasts is good. High blasts are seen with some forms of MDS and leukemia. So why the MDS diagnosis? This doesn't make sense.

Comment : Very few cells and No Mitosis were obtained from this specimen

>> Again an empty marrow is being reported. I'm not sure about the significance of "no mitosis".

Iron stores were not assessable

>> They couldn't measure iron levels, but this could be because the sample was inadequate to do the measurement.

Date report : 16/1/2012
Bone Marrow Trephine

Trephine biopsy consisted of fragmented marrow with blood clots
Bony trabeculae appeared thin
Intertrabecular spares were 10% cellular with increased fat spaces
Occasional megakaryocytes seen

>> Empty marrow. Only a few platelet precursors seen (megakaryocytes).


Interpretation
Bone Marrow Aspiration
Hypocellular marrow
Await Trephine

>> The aspirate is inconclusive for MDS. It just mentions an empty marrow. There is no mention of dysplastic or ill-formed cells or increased blasts, as would be seen with MDS.

Bone Marrow Trephine
Hypoplastic Anaemia

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I would ask the doctor why he is calling her condition MDS. I would be hesitant to try MDS treatment (Vidaza, Dacogen) without a conclusive diagnosis. Was your mom sick while taking the cyclosporine? I ask because viruses can bring down counts, and it can take a significant amount of time for an already struggling marrow to recover.

The shushing sound that your mom hears in her head is a symptom reported in aplastic anemia. She may be hearing her blood pounding through her veins when her HGB is low. I remember hearing this.

Did they do cytogenetics on her marrow sample? There is no mention of this in this report.

It would be good to get another BMB done since this one seems inconclusive.
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52 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. Tried slow cyclosporine taper over 4+ years. Platelets fell, so back on cyclosporine. Trisomy 6 clone in 5% of cells.
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