Bone Marrow and Blood Tests

[Monica Meyer]

How often should people with MDS get a bone marrow test? Can you tell from a blood test if your sideroblasts or blast numbers have increased?
If you receive blood that is expiring the next day or that the date has been revised how long is it good for? Hope I said this right.

[Ruth Cuadra]

Monica,

I don't think there is a standard for the frequency with which MDS patients should have bone marrow tests. The characteristics of MDS vary so much from patient to patient that it would be impossible to quote a "standard" frequency with which patients should have bone marrow tests. In the months after I was treated with ATG for aplastic anemia, I had several bone marrow biopsies to help gauge the status of my marrow as I recovered. When one of those tests showed chromosomal abnormalities (I was re-diagnosed with MDS), I was tested more frequently. By the second year after my transplant, when my blood counts and marrow tests were stable, the frequency of my bone marrow tests were reduced to annual checkups. After 5 years with stable counts, the tests were discontinued.

Blast counts can be measured in the blood and bone marrow, but iron stains are needed to detect ringed sideroblasts.

You have probably already seen the response on AA-MDS-TALK from Wendy Beltrami, our resident expert on issues related to the "freshness" of blood for transfusions, to your question about expiration dates.

Regards,
Ruth

[lotusbud]

Originally Posted by Ruth Cuadra

Blast counts can be measured in the blood and bone marrow, but iron stains are needed to detect ringed sideroblasts.

So part of the diagnosis of MDS is sideroblasts; not having enough iron in the marrow means this part of diagnosis can not be made.
Somebody said earlier that if cytogenetics are normal, then ironclad diagnosis can not and should not be made.
If blasts are below 5%, that is still normal, no?
But if AA reduces the number of cells, and leukemia increases it (usually), then having various combined problems with cell lines should be left with - MDS, by exclusion?
However, immunophenotyping by flow cytometry should be able to pinpoint the types of problems or atypical cells/cell lines who can read that kind of stuff?
-Just trying to make sense out of things..