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Old Tue Apr 20, 2010, 07:19 AM
jojo jojo is offline
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Join Date: Apr 2010
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10% cellularity - what to do now

Good morning. My son (13) had a recent bilateral bone marrow biopsy. It revealed 10% cellularity, moderate thrombocytopenia, as well as neutropenia and lymphopenia. However, his peripheral labs are holding steady at 1.9 wbc, .7 alc, 1.0 anc, slightly low rbc, normal hemaglobin, platelets 130,000, mcv 102.1. They continue to "bounce around" in this area.

The drs have talked about a possible bone marrow transplant should he go into crisis, but right now it's wait and see and frequent blood draws.

I am very concerned about his cellularity. What are the implications of having this low of cellularity????

He does have an underlying chromosome issue, but they are unsure if this is causing his bone marrow failure as there's nothing in the literature to support this.

He's tested neg for Fanconi's, pnh, immunologic causes, and even HIV.

My question is what should I be doing as mom? The dr is comfortable with the wait and see and in trying to rule out the causes, which they have done.

Should we seek a second opinion? If so, where? Our son has a very complicated medical history, including a seizure disorder.

Is it a good idea to wait for crisis? With his lab work being what it is, I know now wouldn't be a good time to do the transplant, but it's the cellularity that concerns me.

How likely is it that a crisis will occur given current cellularity but holding his own peripherally?

Somewhere I read that if you are hypocellular that it's hard to tell if you have MDS. Maybe I did not read that correctly. Anyway, the dr indicated he does not have MDS based on his bmb. Should I feel comfortable that the negative MDS result is accurate?

As for a possible transplant, we've tested our immediate family for a match. So far my result is the only one that's in, and I am not a match. Hopefully I'll match someone else.

When do we start looking for a match with others should our family's not match his? The dr is comfortable waiting on this, but . . .

And to confuse things more, in 2003 his cellularity was 30% They thought it was a site sample issue at that time and not a true representative of his cellularity. He also had a high mcv at that time, but they attributed this to the ketogenic diet used for seizure control.

His labs have slowly trended down since 2003, especially the wbc. Now, looking back, his bone marrow failure probably started back in 2003, especially given his recent bilateral bmb result, but we just didn't know it.

I know transplants are hard on everyone, and a transplant would be extremely hard on him given his underlying health conditions. I just want to make sure in the meantime we are doing everything we possibly can for him!!!

As you can see, we have a lot of questions. Thank you soooo much for your help. We truly appreciate it.

Wishing you all the best.
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