Advanced Member
Posted 27 June 2015 - 09:26 AM
Hello!
Could someone please explain what these terms of a bone marrow biopsy mean?
1. A hypocellular marrow (10% or less).
2.Decreased myeloid to erythroid ratio (1:1)
3.Left shifted in myeloid series with scanty maturation.
4. Stainable iron ( grade 2 out 4).
Advanced Member
Posted 27 June 2015 - 10:15 AM
Overall normal for CML and TKI treatment.
1. Your marrow is low on blood cells. You likely have low CBC blood counts.
2. You have fewer myeloid cells in comparison to lymphoid cells than normal -- typical of TKI drug treatment. If the CML were out of control it would be the opposite.
3. Your have more immature blood cells than normal.
4. Your iron stores are OK
What are you CBC results for WBC and RBC?
Advanced Member
Posted 27 June 2015 - 10:44 AM
Hi Trey,
Thank you for your prompt response!
WBC dropped from 6 to 4.4; RBC 4.5.
1. Is hypocellular bone marrow common during TKI treatment?
2. What is the cellular normal % range in bone marrow?
3.Is more immature cells than mature cells common for CML during TKI treatment?
I was freaked out after I read an article regarding Bone marrow aplasia- a rare complication of Gleevec in CML patients.
Advanced Member
Posted 27 June 2015 - 11:08 AM
Your CBC blood counts are better than many others. This does not show any tendency toward BM aplasia. So why the concern?
You are overthinking these issues. TKI drugs cause the items you asked about. They are not a concern. Your CBC is fine, and better than many others here.
Advanced Member
Posted 27 June 2015 - 11:32 AM
Thank you Trey! Your answer calmed me down a bit. I always read and try to understand the results. Hard to find much regarding bone marrow results.
Advanced Member
Posted 27 June 2015 - 08:09 PM
Sometimes I think I'm grateful that I didn't start collecting my results until everything was heading in the right direction. Only thing I looked for then was a lower result. 
Guest_Karen Louise_*
Posted 17 July 2015 - 06:55 PM
I just had a bone marrow bio. in June. Had an appt. today with my dr. She stated that all my blood work is in the normal range, and very good. My bone marrow still shows cancer. I never ask for numbers, or exactly what it all means, since I am better off not knowing, since I drive myself crazy. My question is how many people are on gleevec, have good blood work, but still have cancer present in the bone marrow?
Advanced Member
Posted 17 July 2015 - 10:48 PM
KL,
How long since diagnosis? The answer to your question is time dependent, but many have "good blood work" while tests still show leukemic cells in the marrow (docs usually mean blood work is good enough for having CML, but not necessarily all normal).
Edited by Trey, 18 July 2015 - 04:32 PM.
Advanced Member
Posted 18 July 2015 - 04:37 PM
Karen Louise,
Knowledge about your disease is always a good thing, learn as much as you can. And, then, when you start to drive yourself crazy, that's what we're here for - to help calm you down, provide support and information you can trust. 
Pat
"You can't change the direction of the wind but you can adjust your sails."
DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>
Advanced Member
Posted 19 July 2015 - 09:57 AM
Hello everybody!
More questions regarding bone marrow results. Does any one know what the following FISH test results mean?
nuc ish(ASS-ABLx3),(BCRx2),(ASS-ABL con BCRx1[3]/(ASS-ABLx2),(BCRx2),(ASS-ABL con BCRx1)[19]/(ASS-ABL,BCRx2[142]
Thank you!
Advanced Member
Posted 19 July 2015 - 10:06 AM
CD 34: staining <than 5 % of cells as blast cells.
Is CD 34 a cancer marker ? or elevated CD 34 level a cancer marker?
Thanks!
Advanced Member
Posted 19 July 2015 - 03:32 PM
MJ,
What does the report say the FISH result was? Should be a percentage.
Regarding FISH:
nuc ish(ASS-ABLx3),(BCRx2),(ASS-ABL con BCRx1[3]/(ASS-ABLx2),(BCRx2),(ASS-ABL con BCRx1)[19]/(ASS-ABL,BCRx2[142]
It appears the lab used several different FISH probes looking for various nuances in your Philadelphia Chromosome. The numbers inside brackets such as [142] are supposed to be a result but it should always be written as [X/Y] where X is the number of leukemic cells found out of Y number examined (often about 200 - 500). So I do not know why your lab result does not report the Y value. Again, what did the report say?
CD34 cells are immature cells, also called blast cells. Yours says less than 5%, but unknown how much less. Maybe 1% for all anyone knows.
Guest_Karen Louise_*
Posted 19 July 2015 - 04:39 PM
Thanks everyone. I was diagnosed in May 2014. I am on gleevec. (which I started in June 2014.) I have not had any side effects other than upset stomach if I don't eat when I take gleevec. I have had 2 bone marrow bio. My dr. says I have to have another one at 18 months, which will be in Dec. I do not want to have another one until the new year, not around the holidays.
I know I should probably know more about this, but believe me I have anxiety ridden as it is (due to many things), and the thought on this terrible disease, I will drive myself crazy.
Advanced Member
Posted 19 July 2015 - 05:55 PM
Thank you very much Trey for your answer!
I can't find any percentage at all. The only thing associated with numbers are:
Number of metaphases assessed:25
The signal patterns were assessed in 280 nuclei.
The doctor said everything was fine, nothing abnormal was found. When I dug into the results, I realized the M/E ratio wasn't right. ....... So, I wanted to understand the FISH result. I don't have clue what it means.
Advanced Member
Posted 19 July 2015 - 06:09 PM
Hi Trey,
Regarding CD34, all it said ; staining of less than 5% of cells as blast cells. No exact %.
Is it a problem only when CD34 is elevated; >than 5%?
Thanks again!
Advanced Member
Posted 19 July 2015 - 07:56 PM
KL,
The way I see it, both knowing and not knowing cause stress. Might as well know, since there is no end to the stress from not knowing.
So at one year you are still detectable in the marrow. That is not unusual. But it depends on the exact numbers whether that "not unusual" is good or not so good. Numbers matter.
After one year on Gleevec many have pretty good blood work. But as I said, most docs do not define that as all blood counts being "normal". And that is OK.
We understand your dilemma over stressing and such. You are among stressed-out friends.
Advanced Member
Posted 20 July 2015 - 07:28 PM
Hi Trey,
I don't know how to do this.I will try to send it tomorrow. Thanks a lot!
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