bone marrow or liver disorder

[JANIE]

six weeks ago my GP sent me to hemotology, i have low platelets and low WBC. no symptoms.....last week i had a bone marrow biopsy and aspiration, hemotolgist .. said that sometimes problems with the liver can have an effect on bone marrow..so he requested that i had abdomen ultra sound last week too... but if i had liver problems why arn't i seeing a liver consultant...any suggestions please, because i am a bit puzzled and have to wait 3weeks for test results...i spoke to nurse at my local docs and she said liver function test were ok...and i have no more useful info about my condition..

[Birgitta-A]

Hi Janie,
Liver disorders can give low platelets and low WBC:s but I think like you do that a liver disease should give other symptoms too.

There are criteria for a MDS diagnosis: http://www.oncologystat.com/Images/main_tcm8-27780.pdf

“Prerequisite criteria
Constant cytopenia (low counts) in one or more of the following cell lineages: erythroid (hemoglobin <11 g dL−1); neutrophilic (ANC < 1500_L−1) or megakaryocytic (platelets <100,000_L−1)

Exclusion of all other hematopoietic or non-hematopoietic disorders as primary reason for cytopenia/dysplasia

MDS-related (decisive) criteria
Dysplasia (the cells don´t look OK) in at least 10% of all cells in one of the following lineages in the bone marrow smear: erythroid; neutrophilic; or megakaryocytic or >15% ringed sideroblasts (iron stain) 5–19% Blast cells in bone marrow smears

Typical chromosomal abnormality (by conventional karyotyping or FISH)c

Co-criteria (for patients fulfilling ‘A’ but not ‘B’, and otherwise show typical clinical features, e.g. macrocytic transfusion-dependent anemia)
Abnormal phenotype of bone marrow cells clearly indicative of a monoclonal population of erythroid or/and myeloid cells, determined by flow cytometry

Clear molecular signs of a monoclonal cell population in HUMARA assay, gene chip profiling, or point mutation analysis (e.g. RAS mutations)

Markedly and persistently reduced colony-formation (±cluster formation) of bone marrow or/and circulating progenitor (very young) cells”

This means that after the bone marrow puncture your haematologist at least should be able to tell you if you have a haematological disease or not – it can be difficult to decide if it is MDS.
Kind regards
Birgitta-A