Bone Marrow Results???

My 23 yr old daughter is being tested for Leukemia, she had an slightly high WBC of 11.7 for over a year..... she does smoke maybe 1 cigarette a day, and sometimes will go 2 to 3 days without smoking.  She was having some joint pain in her feet, which was contributed to gout, because she had a high Euric Acid level.

 She had a BMB done, and we just got the test results back, but still need to see the doctor.

Can anyone dealing with CML, make anymore sense of the tests results, while we wait in the mean time.

It looks like they did not get enough biopsy for a clear diagnosis....

1). Suboptimal Specimen with Cellular Bone Marrow

2). Slightly left shifted Granulopoiesis

3). Absent Storage Iron with no ringed sideroblasts

4). Moderate Increas in Reticulin Fibers

FISH anaylsis shows no BCR/ABl translocation (AGT07-8093). Although there is no apparent evidence of CML, chronic myeloproliferative disorder can not be completely excluded.  Cytogentics studies may be helpful by finding re-occuring cytogentic changes typically associated with CML.  Re-biopsy is recommened if indicated.  Correlation with clinical and other diagnostic information is recommended.

 WBC  11.7 ;  Neutrophils 71 % ; Hemoglobin 13 ; Hematorcit 39.4 %; Lymphocytes 27%; Monocytes 1 %; Eosinophils 1 %

Bone Marrow Differential Count:  Number of Cells counted: 300

Myeloid Cells 76% ; Erythroid Precursor Cells 3 % ; lymphocytes 19%; Monocytic Cells 1%; Blasts 1 %

The C-Kit also stated:  Stained rare scattered myeloid precursor cells.

What does all this mean?? 

Any input is greatly appreciated.

Thank you

Lisa

On 12/26/2007 Lisaj wrote:

My 23 yr old daughter is being tested for Leukemia, she had an slightly high WBC of 11.7 for over a year..... she does smoke maybe 1 cigarette a day, and sometimes will go 2 to 3 days without smoking.  She was having some joint pain in her feet, which was contributed to gout, because she had a high Euric Acid level.

 She had a BMB done, and we just got the test results back, but still need to see the doctor.

Can anyone dealing with CML, make anymore sense of the tests results, while we wait in the mean time.

It looks like they did not get enough biopsy for a clear diagnosis....

1). Suboptimal Specimen with Cellular Bone Marrow

2). Slightly left shifted Granulopoiesis

3). Absent Storage Iron with no ringed sideroblasts

4). Moderate Increas in Reticulin Fibers

FISH anaylsis shows no BCR/ABl translocation (AGT07-8093). Although there is no apparent evidence of CML, chronic myeloproliferative disorder can not be completely excluded.  Cytogentics studies may be helpful by finding re-occuring cytogentic changes typically associated with CML.  Re-biopsy is recommened if indicated.  Correlation with clinical and other diagnostic information is recommended.

 WBC  11.7 ;  Neutrophils 71 % ; Hemoglobin 13 ; Hematorcit 39.4 %; Lymphocytes 27%; Monocytes 1 %; Eosinophils 1 %

Bone Marrow Differential Count:  Number of Cells counted: 300

Myeloid Cells 76% ; Erythroid Precursor Cells 3 % ; lymphocytes 19%; Monocytic Cells 1%; Blasts 1 %

The C-Kit also stated:  Stained rare scattered myeloid precursor cells.

What does all this mean?? 

Any input is greatly appreciated.

Thank you

Lisa

Hi Lisa:  A biopsy is usually the first test done to test for CML, but although the FISH test did not show anything definite.  Ask the doctor to do a PCR ( a Polymerase Chain Reaction Test)  It searches more cells than a FISH test.  ITs just a simple blood test that you get done along with your regular tests.  I think that might be a more simple way to go before putting her through another biopsy.  Also, get a second and third opinion.  Never go with the only opinion you got.  Be sure the doctor is a experienced Oncologist.  I have had CML since I was 52, and I am now 60.  I am monitored with the PCR test every 6 months.  I have been in remission for 6 years with the Gleevec Treatment.  I hope this helps you somewhat.  Lets pray that she does not have CML.

                                                                    Suzzie

Thank you for your response.

We have finally seen the doctor (the only oncologist in this town), and he said in his opinion my daughter does not have CML because  she does not have the Philidelpha Chromesone.  She gets another blood test in 3 months, to monitor her WBC.... Since the lab could not rule out CML conclusively.  I will have her ask her doctor for the blood test you recommened...... hopefully that will give her more piece of mind also.

 It is also nice to hear, that someone is living with CML and is doing well.... when you first hear the Leukemia.... the worst seems to come to mind..... and it's good to know... it doesn't mean your life has ended.

Thank you again for your time and response.

God Bless