Another BMB on Tuesday.

[Dick S]

My numbers are starting to fall a little more quickly now.
Blood yesterday was:

HGB...........10.4
HCT...........31.7
Neutrophils..0.65 K/uL

Oncologist ordered another BMB on Tuesday as he seemed concerned about Neutrophils dropping. Anyone know what the low Neutros mean?
Me, I'm still just dragged out fatigued all the time.
Thanks

[Bill F]

Hi Dick,

So you're reporting an ANC of 650 - that's pretty low and certainly increases your risk of getting an infection. See:

http://www.realnurseed.com/t1000.htm

The fatigue issue is the low hemoglobin especially if it has fallen fairly quickly. When it falls slowly your body accommodates to a degree. My ANC fell to 50 after my first cycle of Dacogen and fortunately I did not encounter an infection at that time. I did however, have eleven infections since being diagnosed with MDS, including MRSA three times! Have seen an infectious disease specialist twice and hope my current routine precludes further incounters with that nasty staph bug.

Anyway check out the link to see what your ANC means.

[Dick S]

Thanks Bill.
Other things I don't understand are:

WBC............2.9
SEGS...........9%
BANDS.........10%

Anybody know how these and the other readings all tie in? Bill, I can't seem to figure out the calculations in your post.

[Bill F]

Hi Dick,

In your initial post in this thread you indicated that your neutrophils were 0.65 K/ul - K is 1000, which times 0.65 is 650 neutrophils per microliter. That would be your absolute neutrophil count (ANC). Different labs report somewhat differently - my CBC shows the WBC, % neutrophils, and the absolute neutrophils. Apparently your CBC didn't include the word "absolute". Many labs, like mine do not break out the bands and segs, but rather just provide the % neutrophils. You can calculate your ANC by multiplying the % neutrophils, in decimal form, times the WBC count. In your case the % neutrophils equals the sum of the bands and segs, 19% or .19 times your WBC count of 2900 (also times 1000). This yields a lower number than 650, but in the same ballpark, ie 550. My lab report also shows a difference in the calculated ANC from that listed for some reason. Fortunately you don't have to calculate your ANC - apparently it's given on your CBC report.

See this link:

http://www.medterms.com/script/main/...ticlekey=20030

Hope this helps.

[Dick S]

Aha and thanks.

[Vera W]

Hi Bill,
in the beginning I googled everything and I was amazed at the wealth of information at my fingertips, just punch in blood tests and you can read what everything on your test is about. It helps you to look out for problems. I did the same thing with my BMB down to every last cell involved. I love to research, I should have been a researcher as I am curious by nature. Always stay on top of your own stuff as best you can..insist on action from the doctor's..Be strong, ask a lot of questions (like you already are) blessings, Vera

[Bill F]

Hi Vera,

Yeah, I know what you mean - I've been googling all things related to MDS since my diagnosis. But, there still are problems, for me, in understanding the bone marrow biopsy and aspirate reports. First there is the nomenclature and then there is the difference in format between the two different labs that performed the biopsies. Fortunately, we see hematologists who can assist in interpretation of these reports. Seems to me the pathologists make no attempt to put the cookies on the lower shelves, so to speak - then again why should they since the report is for the doctor.

I just love the designations CD45 neg, CD45 dim, CD45 bright, such and such stain, gene expression - help! I'm just a struggling layman. Oh sure, I can and do look up these terms, but it's still a terribly hard effort to attempt to put it all together.

[Dick S]

I'm no less than a little disappointed.
After driving 110 miles (that's 220 round trip) I did not get the BMB today. The culprit was that I contacted the gout in my right foot on Sunday so the Hemo says it probably sent my marrow in hyper-activity to fight the gout and all my numbers had gone up from Thursday's readings, so taking a BMB at this time would give a false reading and may not prove anything one way or the other. I'll go back to see him in a month after the gout is gone and see what the new readings will be then. Oh well, more "wait and watch".