Hypocellular bone marrow no abnormal cells

[Lia]

Hi
Can someone please tell me what
Hypocellular bone marrow with no abnormal cells might mean for a 13yr old boy?

I've been given this one snippet of information via email today. He had bone marrow biopsy 2 weeks ago. I can't figure out via searches if this is normal or not normal. GP also has no clue! And consultant out of reach.

Thanks

lia

[Neil Cuadra]

Lia,

Does he have low blood counts, and that's why he was being evaluated?

If so, these are characteristics of aplastic anemia, and that may be what the doctor suspects he has.

"Cellularity" is how they measure the proportion of blood-producing cells in the bone marrow. A 13-year-old would normally have something like 90%. At birth it's 100% and normally goes down about 10% per decade, in rough numbers. "Hypocellular" means this number is lower than expected, which means that there is something wrong.

"No abnormal cells" means that the cells themselves are OK, i.e., there just aren't enough of them. That's a characteristic of aplastic anemia, as opposed to cancers like myelodysplastic syndromes where the cells are misshapen or otherwise damaged. So it's good news that the cells that are found in the bone marrow are normal.

Low blood counts (insufficient red cells, white cells, and platelets in the circulating blood) produce symptoms that lead people to the doctor. The doctor then looks for the cause, one possibility being aplastic anemia.

[Lia]

Hello, thank you for your reply

I was advised today his marrow hypocellular result is 40% and review only no concerns. ??

[AddyGGsMom]

I am in the same boat!! My daughter was diagnosed with Idiopathic Chronic Neutropenia at 22 months. She will have an ANC of 1000-1200 which is mild neutropenia and then will dip below 500-severe. Her first bone marrow biopsy showed >95% cellularity, but a few weeks ago at age 5, 60%. Unfornstely it was my husband who spoke with her about the results but she didn't seem that concerned. Her White blood cell number is always low, between 2-4. It seems to be her neutrophils that fluctuate. Never normal, but not always severe. She is always sick and has reoccurring infections. I'm really nervous and am looking for answers.

[Cheryl C]

Hi AddyGGs Mum - I had chronic idiopathic neutropenia for many years before my MDS diagnosis. Regarding the frequent infections, have your daughter's globulin levels been checked? If these are low (hypogammaglobulinemia) she may be able to have intravenous immunoglobulins which, while they won't fix her neutropenia could help her fight infections more successfully. That is my experience. BTW, re your other post, when I have an infection my white cells and neutrophils sometimes jump hugely as well, and my GP and haematologist view this as a positive. At least the marrow is responding.

[AddyGGsMom]

What changed that made them change your diagnosis to MDS? I just want to catch anything early. I just feel like people that don't fit into the other neutropenias are labeled idiopathic and it's possibly just a precursor to something that is later revealed. I'm not sure about the test you referred to. I will ask the hemetologist. We started on nupogen tonight.

[Hopeful]

Originally Posted by Lia

Hello, thank you for your reply

I was advised today his marrow hypocellular result is 40% and review only no concerns. ??

Hi Lia,

Sorry for the late reply. Sometimes a hypocellular marrow can be the result of a bad virus, drug, or chemical exposure. Doctors will frequently watch-and-wait to see if the marrow will recover on its own, assuming the counts aren't severely low. Perhaps that is why they aren't concerned yet. Be sure to report any changes that you notice in his appearance or energy level.