The initial report from the Bone Marrow Biopsy seems to confirm most of what we already know about my condition, with a few more details and hundred dollar words. The summary diagnosis includes:
- The bone marrow core is hypercellular with estimated cellularity approaching 90 with trilineage hyperplasia.
- Blood shows leukocytosis and erythrocytosis.
- No significant increase in myelofibrosis. (This is GREAT news. YEAYYY!!!)
- Iron stores absent. (helps explain the fatigue)
- Hypochromic microcytic anemia. (helps explain the fatigue)
The myeloid to erythroid ratio is 1:2. There does appear to be progressive maturation of the myeloid, erythroid, and megakaryocytic cell lines. The megakaryocytes are increased. There is hypolobation of the nucleus. Red cells and granulocytic cells also appear to be increased. However, there appears to be progressive maturation without a significant increase in blast forms.
The blood shows leukocytosis and erythrocytosis; however the MCV is low and the RDW is high. The red cell line shows anisocytosis and is hypochromic (low iron).
The microcytic anemia could be due to the alpha thalassemia and/or iron deficiency.
Bone Marrow Item: Units Reference Range
Blasts 4.2 (H) (0.1 – 1.7)
Bands 6.8 (L) (9.4 – 15.4)
Rubriblasts 3.0 (H) (0.1 – 1.1)
Prorubricytes 6.0 (H) (0.4 – 2.4)
Rubricytes 35.2 (H) (13.1 – 30.1)
Metarubricytes 4.2 (H) (0.3 – 3.7)
Total Erythroid 48.4 (H) (15.0 – 36.2)
Lymphocytes 8.3 (L) (8.6 – 23.8)
15.0 (L) (19.0 – 45.0)
M/E Ratio 0.8:1 (L) (1.1 – 3.5)
Other tests take longer to process, so we'll know more later.
I'm back on the Hydroxyurea (HU) now to keep the hematocrit level under control.
The fatigue continues, and my optimism is on the rise. I'm certainly interested in hearing from other MPNers who will share their thoughts on these test results.
Blessings and peace to you,
Marina
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