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Forum Name: Hematology Topics

Question: Bone Marrow/Blood Result = Confusion


 Delia - Fri Dec 31, 2004 10:31 am

Hi,

I have experienced a drop in blood counts over the past year. Primarily WBC, RBC, Hgb, Hct with a high MCV. I then had blood drawn for B12 (much higher than normal), folic acid (normal), Ferritin (normal), Iron (normal) and TIBC (normal). My GP referred me to a hematologist who informed me that I had some form of lymphoprolific disorder and needed a bone marrow. I told him that I'm vegan and asked if it could be dietary and he said no it was obviously a production disorder hence the bone marrow.

The bone marrow was normocellular for age with a single nonparatrabecular lymphoid nodule (they attempted to do immunohistochemistry of the nodule but it wasn't present in the sample they received to use - and recommended clinical correlation). The bone marrow also showed absent iron stores.

The hematologist told me that it was rare for a low white count to occur with low iron but possible, and not to worry about the lymphoid nodule as it was probably normal. He presecribed iron capsules.

I'm confused because none of this makes much sense to me and don't know if I should seek a second opinion or try the iron for a month and have the blood draw repeated.

Thank You
Delia
 Dr. Tamer Fouad - Sat Jan 01, 2005 7:17 am

User avatar Delia,
It is very confusing indeed. In these situations we usually resort to keeping a close eye while at the same time treating any established problems. While it may not be possible to make a correlation between depleted iron stores and the low white blood cells and the lymphoid nodule, we know for sure that you have low iron. So it makes sense to treat the iron depletion for the time being and wait and see. If your counts continue to return low then you may need another bone marrow biopsy.
 Delia - Sat Jan 01, 2005 10:31 am

Morning Dr. Fouad,

Thank you kindly for your respone. That does make more sense to me as I would guess iron is a relatively quick fix and we should know someething soon. I don't relish the thought of another bone marrow though, it's not something I ever care to repeat.

By the way, I wanted to thank you for the time you take to answer the many posts here. I've noticed your name quite often and believe that your posts are thoughtful as well as on target.

Sincerely
Delia

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