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MDS Myelodysplastic syndromes

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Old Tue Jun 11, 2013, 01:19 PM
Wherenext Wherenext is offline
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Post BMB help needed

My 80 year old mothers doctor was real strange last week, he couldn't remember that mom had a BMB the month before, claims to have not yet seen results, said it looked good then said no he has concerns as BMB was dilute of bone marrow aspirate and touch preps. Said it precludes adequate cytologic evaluation. Bone marrow is hyper cellular 65-75% with relative erythroid hyperplasia and mild megakaryocytic hyperplasia. Prominent dysmegakaryopoiesis is observed. CD 34 shows less than 3% nucleated cells consisting of blasts. CD3 shows positive staining 15% nucleated cells concistent with small T lymphocytes. CD20 positive staining less than 5%.
Mild increase in reticulum deposition.

Two unrelated cell lines in multiple cultures. One cell line showed extra copy of chromosomes 8 in 60% cells. The remaining 40% showed translocation between chromosomes 2-3

Trisomy 8 was observed in previous study, translocation between chromosomes 2-3 represents a new colony. The presence of two independent cell populations may suggest two independent hematologist conditions.

Should we insist that they do another BMB? Should we seek another opinion? Or does it look like it has progressed to a point that we just need to make sure she is comfortable and live whatever life she has left in a quality way and not living in a doctors office????

Any help would be appreciated. I have looked up all the individual words but the doctor said that he needed to check with pathologist and that individual words don't explain the whole picture. It was then he told mom further treatment was her option that she seems to hold her own just be careful of infection.
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Old Tue Jun 11, 2013, 03:48 PM
Birgitta-A Birgitta-A is offline
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MDS

Hi Wherenext,
It is not OK that your mother's doctor can't remember that your mother had a BMB one month before. When they look at the chromosomes the answer will take a few weeks.

If I was your mother I should not want to have contact with a doctor who is acting strange - I need to trust my doctor.
Kind regards
Birgitta-A
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Old Wed Jun 12, 2013, 01:20 PM
triumphe64 triumphe64 is offline
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Birgitta,

Good advice. Good doctors are the key with these illnesses.
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Dallas, Texas - Age 75 - Pure Red Cell Aplasia since March 2005 - Tried IVIG - Then cyclosporine and prednisone. Then Danazol, was added. Then only Danazol . HG reached 16.3 March 2015. Taken off all meds. Facebook PRCA group https://www.facebook.com/groups/PureRedCellAplasia/
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Old Wed Jun 12, 2013, 01:55 PM
Wherenext Wherenext is offline
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Thanks for the responses. I agree and would change doctors in an instant. He knows I feel he is incompetent but by doing lots of research and demanding answers he is getting the point. I have fired many a doctor not only for me but my parents as well. My mother doesn't want to change so I am working real hard to get her to at least get a second opinion on treatment. 80 year old stubborn women are hard to change.
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