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Old Sun Oct 21, 2012, 11:29 PM
KMac KMac is offline
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Join Date: Oct 2012
Location: Golden, Colorado
Posts: 103
Hi,

I have wondered the same with my own MCV and RDW counts, although my pattern has been somewhat different that yours.

I needed my last red blood transfusion about 4 1/2 months ago. For about two months after that, both my RDW and MCV went up steadily, while my red blood counts fell more slowly than normal, and then hovered just above transfusion levels (Hgb 8.0 in my case). Then as my counts actually started to rise, my RDW started to fall (from high 20s to about 15 like yours) and my MCV held in place. That is the trend that continues for me to this day (Hgb 11.4). But my MCV is quite high at about 112.

I was kind of worried about my high MCV and RDW, as I read it could be a sign of MDS and/or leukemia, but none of that came up in my BMB last month, and my Doctor had told me not to worry about that. He said most likely, my marrow is just so stressed it is struggling to make cells as large as it can, to compensate for the fact that it still isn't making a normal amount of them.

My understanding is my lower RDW is because at this point, all the transfused cells are gone, and my entire RBC is made up of my larger than normal, but more uniform in size, cells from my own marrow. I think this is termed 'macrocytosis', a common feature of SAA. In your case, seems you don't have macrocytosis, especially not as of late, so it might be a good sign that your marrow is getting less stressed. I'd guess the best sign would be increasing duration between transfusions. You are going longer than I was though, I needed 2 units every 10-15 days for a while.

I am sorry I don't have a definite answer to your question though, but thought my experience might be a bit helpful for comparison.
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Kevin, male age 45; dx SAA 02/2012 - Hgb 5.8, platelets 14, ANC 200, 1% cellularity. Received ATG 03/2012. As of 03/2015, significant improvement - Hgb 15, platelets 158, ANC fluctuates around 1000, Lymphocytes 620. Tapering cyclosporine. BMB 20-30% cellularity.
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