BMB questions

[Delo3]

Hi-what a great group and site to try to make sense of things. I have had a low WBC for a number of years. It has continued to be low and is now staying in low ANC. A while back I had a BMB which didn't shed much light on my neutropenia. My count has stayed low and now primary care physician is asking me to follow up again with hematologist. My hematologist never explained anything (maybe nothing to explain) so I will look into new dr as well.

Most recent ANC was .6 other blood counts seem okay. I did have a number of years using benzene in work environment (before it was banned) which I am now thinking could be cause of low white count. While I know you aren't drs but any thoughts on these? It seems ridiculous that a dr can't follow up in explaining things. Is it ok to wait-or could something be treated if it were going on? Any thoughts appreciated! Thank you!!!

Leukopenia with a moderate absolute neutropenia with low-normal absolute lymphocyte monocyte count.

Rare activated/transformed lymphocytes noted. Some of the neutrophils seen on scanning show toxic changes and a left shift.

Cell Type % Range

Promyelocyte 0.0 (1.9-4.7)
Myelocyte 8.0 (8.5-16.9)
Metamyelocyte 4.8 (7.1-24.7)
Bands & PMNs 31.0 (13.2-26.4)
Monocyte 3.4 (0-0.6)
Basophilic Erythroblast 2.4 (0.4-2.4)
Poly & Ortho Erythroblast 34.0 (13.4-33.4)

A single lymphocytic aggregate, and a non-peritrabecular location, composed of small mature lymphocytes.

CELLS GATED: Lymphs
ANTIGENS NORMALLY PRESENT ON LEUKOCYTES
% OF GATED CELLS NORMAL RANGE
CD45 100 (>98%)
ANTIGENS NORMALLY PRESENT ON B CELLS
CD19 12 (2-18%)
CD20 15 (2-18%)
KAPPA 9 (1-15%)
LAMBDA 5 (1-15%)
KAPPA/LAMBDA
RATIO 1.
8 (1.0-3.0)
ANTIGENS NORMALLY PRESENT ON T CELLS
CD2 (PANT T, NK) 66 (62-92%)
CD3 (PAN T) 39 (62-92%)
CD5 (PAN T) 50 (62-92%)
CD7 (PAN T, NK) 76 (62-92%)
CD4 (T HELPER) 23 (35-58%)
CD8 (T SUP/CYT) 16 (16-32%)
CD4 TO CD8
RATIO 1.4 (1.0-3.0)

OTHER ANTIGENS:
CD5+CD20+ 0 (<1%)
CD19+CD10+ 0 (<3%)
CD56 26 (5-25%)

Four color flow cytometric evaluation of the specimen using CD45, CD19, CD20, Kappa, lambda, CD3, CD4, CD8, CD10, CD34, CD33 and CD117 show that 26 percent of all CD45 positive cells are lymphocytes, of which 12 percent of polyclonal B lymphocytes and 39 percent are T lymphocytes with unremarkable CD4 to CD8 ratio. NK are 26%. Blasts are one percent and are CD34 positive, CD117 positive and CD33 positive or negative.

[JennyM]

Hi,

I understand your frustration but to understand your BM results you have to look at the pathology report examining your cells what you shared there is almost no way to determine what is going on. My report had all that to but when you go to the pathology report it will bw a paragraph of findings like mine

for ex:

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.

So this says the cells found those immature ect.
hope this helps

[Leigh Clark]

HI Delo3 - If you need help locating an expert, contact AAMDSIF, 800-747-2820 x140 or email help@aamds.org.