Bone Marrow Biopsy

[Hispit]

I am very interested in reading my lab and BMB reports...and wanting to understand what every little thing means... normal vs. abnormal values...what abnormal values mean, etc etc etc.

Anyone know of a website that show a BMB value list??? Meaning: the CD+ #'s... I want to be a little "one-up" when I visit my Hema Dr on Monday... Am tired of him telling me that everything is 'inconclusive' when in reality it is not.

Hispit

[Birgitta-A]

Hi Hispit,
You know reading BMB reports is very complicated. There are tables showing the reference range for different cell types and for grading fibrosis but many expressions are only reported in articles with a lot of difficult words.

Here is a link to a book about the bone marrow. You can find results from biopsy from normal adults at page 36-37:
http://books.google.se/books?id=LWez...0cells&f=false

Here is a link where you can find typical bone marrow changes in AA patients:
http://www.pathconsultddx.com/pathCo...675(06)70097-3

CD means Cluster Designation and is a nomenclature system for surface antigens of human leukocytes (white blood cells), macrophages (big white blood cells acting in infection defense), platelets, and other cells, characterized by monoclonal antibodies, allowing these cells to be categorized by lineage.

Grading of myelofibrosis (MF)
Grading Description
MF-0 Scattered linear reticulin with no intersections (cross-overs) corresponding to normal bone marrow
MF-1 Loose network of reticulin with many intersections, especially in perivascular areas (around the blood vessels)
MF-2 Diffuse and dense increase in reticulin with extensive intersections, occasionally with only focal bundles of collagen and/or focal osteosclerosis
MF-3 Diffuse and dense increase in reticulin with extensive intersections with coarse bundles of collagen, often associated with significant osteosclerosis (hard bone).
Kind regards
Birgitta-A

[Lisa V]

Hispit, the main thing you want to know about your BMB results is a) what is your marrow cellularity, and b) do you have any dysplasia or chromosomal mutations?

A cellularity of less than 25% could indicate Severe Aplastic Anemia, but only if you also have at least two of the following: an ANC of less than .5, a platelet count of less than 20, a reticulocyte count of less than 20. Did they do a retic count? Those are the precursers of red cells, and what is going on with them may help solve the puzzle. From your other post, your platelet count is excellent, and your overall white count sounds good too, so I can't imagine your ANC being anywhere near that low. That would seem like enough to rule out AA to me, but it would be useful to know what your cellularity is. There is another category known as Moderate AA, which is basically defined as having lower than normal counts, but not low enough to qualify as SAA. Maybe this is what your doctor is thinking of, but I still don't think that having only low RBCs would point to that. On the other hand, if your cellularity is low, that may be why they're leaning in that direction. These are all questions to ask.

If there are signs of dysplasia (deformed cells) or chromosomal mutations, that would be more typical of MDS, but it's often not a simple call. There's a lot of grey area and room for interpretation in some of the things they look at. My gut feeling is that you probably have neither AA nor MDS, but it would help a lot if your doctor would explain your test results to you and why he or she has come to the conclusions they have.