diagnose in 2003 MDS have question please reply

[JennyM]

Though diagnosed in 2003 at the VA have not recieved any treatment though have had constant infections, low white count and plt. the only thing they have done was the filgastrum injections once a week.
though is that just a band-aid, my counts got really low neutropenic I'm going outside the VA to see a hematologist he took me off filgastrum and am schedualed for another BMB april 16th though have been really tired, had bruising is he waiting to long my next appt. isn't until april 30th

here's my first BMB

can someone share if I should be worried I'm 46 yrs. old now The bone marrow aspirate shows trilineage hematopoiesis and full maturation. The M:E ratio is 1.2:1 due to erythroid hyperplasia. The erythoid cells also show megaloblastoid changes and dysplastic nuclei are seen in a few normoblasts. A few granulocytes show hypolobation and hypogranular features. There is an adequate number of megakaryocytes.

The core biopsy reveals a cellularity of 50% with erythroid hyperplasia.

Abnormal localization of immature precursors is not present.

Megakaryocytes are normal in number, but many cells are hypolobated and/or microcytic. Normal hematopoiesis and maturation are present in three cell lines. The bony trabeculae are unremarkable. PAS and Giemsa stains are confirmatory. Iron stain detects no stainable iron.

DIAGNOSIS:
BONE MARROW, POSTERIOR ILIAC CREST, SIDE NOT SPECIFIED, CORE BIOPSY AND ASPIRATE:
‐ Refractory cytopenia with multilineage dysplasia, mild.
Comment: The patient has anemia and leukopenia with mild dysplastic changes in three cell lines. The erythroid series shows megaloblastoid changes with dysplastic nuclei demonstrated in a small percentage of normoblasts. The granulocytes reveal hypolobation and/or hypogranularity in a few cells. The megakaryocytes show hypolobation and microcytic forms.
Supplementary Report: