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Old Mon Nov 14, 2016, 09:07 PM
Neil Cuadra Neil Cuadra is offline
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Join Date: Jul 2006
Location: Los Angeles, California
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shellybean,

Welcome to the forums.

The bone marrow test is actually two procedures: a bone marrow aspiration and a bone marrow biopsy. The former involves removing bone marrow fluid to study the cells inside. The latter involves removing a small piece of bone to study the structure of the bone marrow and the quantity of cells, called "cellularity". Confusingly, people often use the phrase "bone marrow biopsy" to mean both of these procedures, since they are done together.

It's typical that you get blood test results back quickly and bone marrow test results back days later, because the extracted bone marrow and fluid have to be examined by the lab technician, who usually writes up a report for the hematologist. You can ask for a copy of this report, but it's typically hard for a layperson to interpret all the jargon.

"Your bone marrow is empty" means that you have low cellularity, meaning the percentage of your marrow that consists of blood cells. At your age, normal cellularity might be 75%, 80%, or more. Ask the doctor what your cellularity measurement actually was.

Ask for your blood test results too, each time you have a Complete Blood Cell (CBC) test. Those numbers are much easier to interpret, since there are normal ranges for each type of blood cell. You'll be able to see which are low, how close to normal or far from normal they are, and how they change over time.

When you have low cellularity, you are low on the immature (baby) blood cells that mature in the marrow until they become mature blood cells in your circulating blood. When you have low cellularity, the doctor is likely to get fewer cells during a bone marrow test (there's just not as much in there to sample). That may be why they are talking about doing another bone marrow biopsy.

The word for "missing cells" is aplastic (they also say hypoplastic), and one explanation may be the disease called aplastic anemia. It does sound like the doctor described your condition as aplastic anemia but you'll want to ask to make sure. When aplastic anemia is suspected or confirmed, it's a good idea to check for the related condition called PNH, in which red cells are lost.

Many people have been diagnosed with aplastic anemia in their 20s. It can be treated, but it's still a serious illness, so it's important to educate yourself and make sure you have the support you need. In case you do have aplastic anemia, I suggest that you order the free information here. Choose Aplastic Anemia from the drop-down box.

You asked about preparing questions. That's an excellent idea before an appointment. Your goal should be to find out what the hematologist knows from your tests so far, if you have a diagnosis, what needs to happen next, and what choices need to be made. Here is a list of questions you might ask, especially after you have a firm diagnosis. Don't be shy about asking the doctor to explain something in terms you can understand. Reading educational materials and looking at websites will help you learn some of the terms, but a good doctor will meet you more than half-way in providing explanations you'll understand.

Feel free to post questions here too. Most forum members are patients or caregivers without medical training, but we know plenty about our own experiences.

Good luck.
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