[David E]

Hey everyone. I've been reading this site for a few days now...ever since my primary care doctor said I needed to see a hematologist for possible BMB. Lots of very helpful information here...Thanks!

I'm a healthy 48 year old white male; normal weight and no symptoms. I've had annual physicals now for the last 10 years and because the last one indicated low (out of range) WBC (4.4), RBC (4.37), & PLT (111), my Dr became concerned. But if I compare these values to the reference range from the last lab I went to last year, the WBC & RBC would be within the normal range? And I had similar values two years ago WBC (4.8), RBC (4.34), & PLT (100).

The other thing I noticed and my Dr did not mention (although he may be factoring into his decision) is that it appears my levels have been slowly dropping over the past 10 years. My platelets have always been considered low, when compared to lab reference range, but WBC & RBC have typically been in the normal range. Here are the high/low values over a 10 year period. WBC (6.2/4.4), RBC (5.2/4.31), PLT (150/100), HGB (15.2/13.3) & HCT (44.2/38.3). The drop has not been a straight line and my lowest values were not necessarily recent but the overall trend has been downward.

So my questions are, is this slow gradual drop typical of AA, ITP or MDS? Do you think maybe my doctor is over-reacting or are his concerns valid? He did not test me for iron but he did test my B12 (765pg/mL) & Folate (>24.0ng/mL) which were normal. My insurance is not the greatest and I'm pretty sure the BMB is going to be very expensive? And scary! Are there other things he could be testing? I did have a bout of anemia as a child (3-4) and was given iron supplementation to correct. Any thoughts or info is greatly appreciated.

Thanks

David