2 replies to this topic

[Widgeonus]

First post here and I'm coming for info. Just got my bone marrow results and cannot get in touch with my doctor. Was dx in July 2013 and took my first pill July 31st. Was taking ponatinib until the announcement of cardiovascular issues came out and then was switched to Gleevec. Could someone please let me know what this means especially the statement "Cellular (40%) marrow with trilineage hematopoiesis" Thanks in advance.

BONE MARROW DIFFERENTIAL

BM Method Smear

Adequacy Adequate quality

Site Left Posterior Iliac Crest

Total cells counted 500

Blasts 1 % (0-5)

Progranulocytes 1 % L (2-8)

Myelocytes 6 % (5-20)

Metamyelocytes 6 % L (13-32)

Granulocytes 21 % (7-30)

Eosinophils 5 % H (0-4)

Basophils 0 % (0-1)

Lymphocytes 17 % (3-17)

Plasma cells 2 % (0-2)

Monocytes 5 % (0-5)

Reticulum Cells 0 % (0-2)

Pronormoblasts 1 % (1-8)

Normoblasts 35 % H (7-32)

M:E Ratio 1.1 L (3-4)

by: p192940

NOTE: Normal ranges apply to adults only. Call

the Diagnostic Bone Marrow Laboratory

for pediatric reference ranges.

BONE MARROW CLOT

Quality: Adequate, small particles present

Cellularity: 40% (may not be representative given the small size of particles)

Megakaryocytes: Adequate, occasional monolobated form seen

Infiltrate: Not seen

BONE MARROW ASPIRATE

Quality/cellularity: Adequate

Granulocytes: Decreased, progressive maturation, unremarkable morphology

Erythrocytes: Increased, progressive maturation, unremarkable morphology

Megakaryocytes: Present, unremarkable morphology

Lymphocytes: Not increased

Monocytes: Not increased

Blasts: Not increased

BONE MARROW DIAGNOSIS

Bone marrow, left posterior iliac crest, clot and aspirate:

Cellular (40%) marrow with trilineage hematopoiesis

No morphologic support of chronic myeloid leukemia (see Comment)

[Trey]

Excellent report.  Nothing much wrong, including no sign of CML in the marrow cell count ("No morphological support of chronic myeloid leukemia"), so you are Complete Cytogenetic Response (CCyR).  "Total cells counted 500" means FISH was  zero, also showing CCyR.  So this is a great result for just over 6 months.  Of course, your PCR would likely still be positive, so you should focus now on PCR tests.  You may be a little low on WBC, but many of us are.

"Trilineage hematopoiesis" means you have the normal three types of blood cells (Myeloid, Lymphoid, Erythroid) so that is good.

Cellualrity is about normal, but varies with age.  It is just a ratio of blood cells to fat inside the marrow.  You do not want much more than 40 - 65% cellularity in the marrow.  See link below. 

http://www.pathologystudent.com/?p=645

You are doing very well.  Congratulations.  Celebrate.

[Widgeonus]

Thanks Trey. I have been driving myself nuts worrying about this disease and I really needed something positive.