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Bone Marrow Failure Causes, treatment approaches, terminology, related diseases

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  #1  
Old Tue Dec 12, 2017, 02:06 AM
Naive Naive is offline
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Blood film

Hi, I recently received a copy of my blood results with a blood film report.

I understand most of it but although I know what these terms are, I donít know their significance.

Hb 79
Hct 0.27
Rcc 3.6
Mcv 77
Mch 22
Mchc 287
Plats 150 only normal count
Neuts 1.2
Lymphs 0.6

Thatís ok. These are as good or better than normal.

However the report says dimorphic (yep, know what that means) normocytic and normochromic (know what that means) red cell fragments present, nucleated red blood cells present, platelet anisocytosis with large and giant platelets.

I donít know if the last part of the report is significant. Iíve also noted a couple of my biochemistry results are a bit off too. My ca, protein are low and couple of my liver enzymes high. The ALP has always been a little raised but itís steadily climbing each test and now my AST increased on the last couple of tests as well.

Iíd be grateful if anyone has insight as I donít have any appt with the haematologist for months and my Physician doesnít seem to check my blood results (except the hb for transfusion purposes).

Thank you.

Carol.
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  #2  
Old Thu Dec 14, 2017, 05:17 PM
Naive Naive is offline
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Iíve made the mistake of Googling the results.

Iíve been told my BMB (done a year or so ago) showed some dysplasia but not enough for a diagnosis of MDS. I also had a chromosome deletion but it wasnít one usually associated with MDS. But now that Iíve seen the blood film report and I have these new changes Iím wondering if my disease is changing or progressing.

The nrbcs and the large and giant platelets seem to be an indicator of MDS or malignancy. The red cell fragments and raised liver function tests can show haemolysis.

I feel a little disappointed that my Doctor doesnít seem to have even looked at my results in detail for the last few months. The only result he ever mentioned was the Hb and the neuts (when they were a lot lower). I have no follow up appts with the haematologist scheduled and the Physician doesnít seem to want to address any issues other than the anaemia and blood transfusions.

Would it be appropriate for me to try to contact the haemotologist and ask him to review and explain my test results? Or am I being overly concerned about nothing much?

I would appreciate some advice.

Carol
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  #3  
Old Sun Dec 17, 2017, 12:33 AM
Hopeful Hopeful is offline
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Hi Carol,

I think it would definitely be appropriate for you ask your doctor to explain your results and the possible causes. I don't know the significance of the blood dysplasia that you have listed or if it is indicative of MDS or something else.

Sorry I can't be of more help! I don't want you to think that no one is listening out here

You need to understand the cause so that you can hopefully get off the transfusions.
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50 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. Tried slow cyclosporine taper over 4+ years. Platelets fell, so back on cyclosporine. Trisomy 6 clone in 5% of cells.
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  #4  
Old Mon Dec 18, 2017, 12:08 AM
Naive Naive is offline
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Thank you Hopeful. I still donít know if my results mean anything has changed. I rang the haematologists office and asked if he could look at my recent results and let me know if I needed to do anything. I received a phone call back from the secretary to say the haem had booked an appointment for me to see him on Jan 14.

Iím assuming he wants to discuss the results but it could be just a routine visit...I donít know.

My mother passed away 2 months ago and Iím trying to care for my father and while heís still physically fit for a 90yo, he is grieving terribly and I feel Iím not able to be as supportive as I should be because Iím so incredibly weary. The tiredness seems to be so deep itís inside my bones. Itís hard to describe.

I just need to remain patient and do my best to eat well and stay well until I get some answers.

Carol.
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  #5  
Old Mon Mar 5, 2018, 05:05 AM
Naive Naive is offline
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Iíve got another question. I was told today that Iíve got heart failure. This was because of the result of a blood test. I need further tests to see if the EF is normal or not to see if itís treatable. My blood pressure is very low.

Okay, so is it possible that heart failure can contribute to haemolysis. Iíve got a raised LDH and ALP.

Iím in the middle of my 3rd blood transfusion in 4 weeks. Thatís a massive change in transfusion requirement.

Iíve also had a few falls lately and currently on bed rest (and these nurses are strict!) for torn ligaments in my foot and ankle. The week before I fell and twisted my other ankle and the week before that I fell and injured my wrist. Iím feeling very debilitated. Iíve spent 4 of the last 5 weeks in hospital and feeling very pessimistic about my future.

The heart failure news was a bit of a shock...certainly had never crossed my mind.

Iíve read that valve disease and regurgitation can cause haemolysis but as far as I know I donít have valve disease.

I donít know if I even expect an answer. Kind of writing out my thoughts as a therapy.
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  #6  
Old Mon Mar 5, 2018, 10:02 PM
Cheryl C Cheryl C is offline
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Hi Carol. I'm so sorry to hear your latest news. You have obviously been going through a very tough time, and still are.

I'm sorry I can't offer any answers to your medical worries, except to say that sometimes haemolysis occurs simply because your blood hasn't been dealt with quickly after it's been taken by pathology.

I just want to send you my thoughts and prayers.

Keep posting!
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Dx MDS RAEB 10% blasts + hypogammaglobulinemia, Sep 2011. Jan 2012 BMB - blasts down to 2% w/out treatment so BMT cancelled. Re-diagnosis RCMD. On watch and wait since Feb 2012. IVIg 4-6-weekly. BMB Feb 2014 - no blast transformation. 2017 still stable.
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  #7  
Old Tue Mar 6, 2018, 09:02 AM
JoMac53 JoMac53 is offline
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Carol, my condolences on the death of your mother and I hope your father is doing better. I'm sorry I have nothing I can say that would be helpful regarding your blood work.

I've recently (a few weeks) developed low blood pressure myself and wonder about heart failure but I don't find much online connecting the two. How low has yours gone?

Mine is fairly consistent now in the high-80 over high-40 range (example 87/48) but my oncologist doesn't seem concerned other than to ask what my medical doctor is doing about it. I see medical doc next month but whenever I'm at the infusion clinic it reads higher so I don't think my medical doc will even believe me. (Home monitor is working correctly, my husband gets normal-to-slightly high readings.) I also only occasionally have other symptoms like fast heart rate or weakness or dizziness. I've not fallen but having been a caregiver to several people with brain injuries from falls I'm extremely careful about that.
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Jo, 63F; Dx May '17 w/Pancytopenia; Aug '17 w/Primary MDS RAEB-1, Intermediate-1. Weekly Granix shot with Claritin, Percocet, Xanax & Tylenol (my bone-pain cocktail).
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  #8  
Old Tue Mar 6, 2018, 10:29 PM
Naive Naive is offline
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Hello Jo. I didnít even realise low BP could be associated with heart failure. Everyone always talks about high blood pressure.

My BP is in the low 90s at the most, usually sits in the mid/low 80s and sometimes drops to the mid 70s. The bottom reading can be anywhere between 55 down to 38. This is documented on my obs chart and has been low for at least a year. I have fainted at home when Iím sure itís dropped even lower.

My pulse is between 55 and down to 45.

The test my doc did was a BNP I think. Apparently it not only diagnoses heart failure but is used for monitoring the progression. He said it could be caused by chronic anaemia and muscle weakness. Now Iím just waiting to see if the echo shows if the ejection fraction is normal or low. Apparently normal EF is bad because thereís no treatment available.

I get to go home tomorrow and Iíll get a call to let me know if I need any further tests or treatment so it canít be too bad.

Just another medical problem to add to the list.

It seems to be easy to find out if you have heart failure. Iíd ask your Doctor for the BNP blood test.

Good luck.

Carol.
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  #9  
Old Wed Mar 7, 2018, 05:08 AM
lisa3112 lisa3112 is offline
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Hi carol,
You should ask about heart failure nurses. I am a cardiac nurse. Its a good idea to weigh yourself every day to see if you are fluid overloaded. If you put on weight it is an indication you may need diuretics. Yes, cardiac failure is scary, but you can manage it. I hope your echo is OK. Heart failure can cause elevated liver enzymes (ALT) because of congestion.
Please post if you have any questions about heart failure, I can try and answer.
Lisa
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Now 30yr old. Diagnosed AML dec 2015 (Most likely MDS prior). Trisomy 6. Runx1 mutation also. Had induction and consolidation chemo. Marrow failure ++ so SCT on 21st of March with MUD. Married with a 1yr old!
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  #10  
Old Wed Mar 7, 2018, 05:12 AM
lisa3112 lisa3112 is offline
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Also I just read you mum passed away, I'm so sorry. There is a condition called takusubo syndrome, which essentially causes heart failure after extreme stress. Did you ever have chest pain? Ask your Dr about this too. I have seen a number of women suffer from this.

Good luck.
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Now 30yr old. Diagnosed AML dec 2015 (Most likely MDS prior). Trisomy 6. Runx1 mutation also. Had induction and consolidation chemo. Marrow failure ++ so SCT on 21st of March with MUD. Married with a 1yr old!
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