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Forum Name: Hematology Topics

Question: HIGH WBC, HIGH ANC, HIGH RDW, HIGH PLT, LOW MCV, LOW MCH


 mmr1171 - Mon Aug 09, 2010 11:59 am

Have had problem past few years with my WBC had a previous bone marrow biopsy that I never got the result of till recently.. This is not the full results but what I know . Progressively maturing dysplastic granulopoesis Cellularity 50%, E:R ratio 4:1 , hypochromic erythropoesis, mild plasmacytosis and decreased stainable iron with a WBC at that time of 15.4 hgb 11.4, hct 26.1 mcv 74 mch 24.2 rdw 16.1plt 375 , neutrophils 58% lymph 36.8 mon 2.6 eos 2.1% iron level 17 TIBC 313% Ferritin 16.2 vit B12 291.

Then 2 months ago they sent me for MRI after things didnt work found hyper celluar bone marrow, white count 19400, Absolute neutrophil count 15400 that is double what it should be. Iron has improved to 28, HGB HCT norm, vit b12 went up to 410 but RBC increased to 5.61 platelets 4.61 MCV 74 low, MCH 23 low, MCHC low, with a normal hemoglobin electropheresis I would like to know what the above bone marrow biopsy means from previous and what u think this could be. Thanks
 Dr.M.Aroon kamath - Fri Sep 03, 2010 9:04 am

User avatar Hi,
Your description of the bone marrow picture lacks clarity and detail. Is it possible that you mean dysgranulopoiesis?

Dysgranulopoiesis is characterized by abnormal nuclear configuration (hypo or hypersegmented, or bizarrely segmented nuclei) and abnormal cytoplasmic granulation (hypogranularity or abnormal granules). Pseudo Pelger-Hüet neutrophils are frequently seen. Dysgranulopoiesis may occur in a variety of myeloproliferative or myelodysplastic syndromes and in some cases of primary or secondary AML. Chromosome 17p deletion has been reported to be strongly associated with dysgranulopoiesis in MDS and AML. Dysgranulopoiesis has been noted to occur shortly before CML transformation.

The bone marrow picture that you describe, in some ways, suggests a myelodysplastic syndrome (MDS) with erythroid hypoplasia with a suspicion of early CML transformation.It will be better if you could send a clear description of the bone marrow picture so that a meaningful interpretation becomes possible.
Good luck!

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