Bone Marrow Biopsy Changes

[rich7]

Hello All,

Previous bone marrow was hypocellular at 20-30 percent with dsymeyelopoiesis and dysmegakaryopoiesis as well as 5q loss of heterozygosity. CD 56 was present as well.

Recent bone marrow now is noted as mildy hypercellular at 50 percent with moderately increased megakaryocytes and show atypia to include hypolobation, focal hyperchromasia and few small forms. CD 61 moderately increased. Leukopenia and focal iron stores noted. This recent bone marrow does not show 5q deletion..very strange. Well demarcated Lymphoid aggregates with condensed chromatin also present.

I moved and have a new oncologist who is reworking me up for MDS.

Can anyone please clue me in on what this means also how bone marrow went to hypercellular? Any information is appreciated.

[Matthew42]

Originally Posted by rich7

Hello All,

Previous bone marrow was hypocellular at 20-30 percent with dsymeyelopoiesis and dysmegakaryopoiesis as well as 5q loss of heterozygosity. CD 56 was present as well.

Recent bone marrow now is noted as mildy hypercellular at 50 percent with moderately increased megakaryocytes and show atypia to include hypolobation, focal hyperchromasia and few small forms. CD 61 moderately increased. Leukopenia and focal iron stores noted. This recent bone marrow does not show 5q deletion..very strange.

I moved and have a new oncologist who is reworking me up for MDS.

Can anyone please clue me in on what this means also how bone marrow went to hypercellular? Any information is appreciated.

Dear Rich,

How are you? Nice to meet you.

I think it's a really good thing that the 5q is no longer there. So happy for you.

I'm curious to know if you ever had a small PNH clone in your initial bone marrow biopsies. Did you have aplastic anemia at one time?

People with MDS and aplastic anemia can have radical changes in their bone marrow from one biopsy to the next. They're both very unpredictable.

You have dsymeyelopoiesis and dysmegakaryopoiesis, which means you have abnormal white blood cells and platelet cells. What is important here is the percentage of those cells. Do you know what they are? Do you have any meyloblasts in your peripheral blood (that is, blood taken from your veins)? I wouldn't think you would.

I don't know much about the hypercellular part, other than the fact that the vast majority of people with MDS are hypercellular. Once in a while, someone will be diagnosed with hypocellular MDS, but it's usually not a clear-cut case of MDS, often showing signs of aplastic anemia as well.

My mother has classic aplastic anemia, with an occasional occurrence of dysplasia (megaloblasts) in her red blood cells (platelets and white blood cells were all normal). My mother's doctor said that dysplasia in small numbers has little meaning, no matter what line it's in (white blood cells, red blood cells and platelets). It's only when they are in greater number do you get concerned (15% or more??). And strangely, sometimes dysplasia vanishes from one biopsy to the next. Very bizarre.

Please take care of yourself. You'll be just fine.

Matthew

[rich7]

Thank you Matthew. I do not have percentages but I will look into this and I have not been diagnosed with AA in the past. I also see I have the Notch 1 and Fancd 2 mutations.