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Old Mon Feb 4, 2019, 02:39 AM
kubu kubu is offline
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Join Date: Feb 2019
Location: South Bay, Los Angeles
Posts: 7
Question Aplastic w/ 10% bone marrow and decent CBC?

13 months ago (Dec 2017) my neutrophils and WBC came back low from my annual physical. Doctor recommended a hematologist visit, which I did at UCLA.

The hema at UCLA totally blew it off. Basically saying nothing to worry about and if I am concerned, just get another CBC in a few months to be 100% certain.

Given how confident the hema was that it was a normal variance, I did not get CBC until my next physical one year later (Dec 2018). Here were those numbers, as well as prior years.

Neutrophils absolute
Dec 2018 1.01 [L]
Dec 2017 1.07 [L]
Dec 2016 2.13
Sep 2016 4.36
Dec 2015 7.05

WBC
Dec 2018 3.4 [L]
Dec 2017 3.8 [L]
Dec 2016 4.8
Sep 2016 7.1
Dec 2015 10.1

RBC
Dec 2018 4.17 [L]
Dec 2017 4.37
Dec 2016 4.68
Sep 2016 4.69
Dec 2015 4.59

HGB
Dec 2018 12.9 [L]
Dec 2017 13.8
Dec 2016 15.3
Sep 2016 14.9
Dec 2015 14.9

HCT
Dec 2018 38.5 [L]
Dec 2017 40.4
Dec 2016 48.2
Sep 2016 45.0
Dec 2015 47.1

I am 34 y/o male and very athletic (1.5-2 hours intense exercise 6 days/week). Therefore, the fatigue was something I definitely noticed. My primary referred me to a different hematologist and he was very concerned and ordered biopsy. Got results this past week and both pathologists who reviewed the results concurred:

Quote:
SEVERELY HYPOCELLULAR BONE MARROW (EST. 10%) WITH REDUCED TRILINEAGE HEMATOPOIESIS

The morphologic and immunophenotypic findings show marked decrease in normal hematopoietic elements. No apparent etiology is noted. There is no evidence of acute leukemia, significant dysplasia or a lymphoproliferative disorder. Overall the findings are compatible with severe aplastic anemia. Causes of aplasia such as medications, systemic/autoimmune disorders, toxic exposures, viral infections (including EBV and hepatitis), etc. should be considered in this patient. Clinical and genetic correlation is recommended (cytogenetics pending). Two other issues should be noted. First, there is an increase in plasma cells seen for patient of this age. These are not specific but increases are seen in chronic infections and autoimmune disorders. Second, the peripheral blood lacks Howell-Jolly bodies, nucleated red blood cells and significant anisopoikilocytosis of red blood cells. Given the history of splenectomy, these findings are unusual and suggest that the patient may have an accessory spleen.
With 10% marrow remaining, shouldn't my numbers be a lot worse? My platelets in Dec 2018 were 351 (150-450 being referenced normal range).

Ultimately my question is... how much longer should I expect until my life really goes down hill and these not good - albeit decent - CBC results really take a nosedive?
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