Bone Marrow Biopsy for Anemia

Gwfl

My Oncologist has recommended a bone marrow biopsy because of my continous low hymogloben counts and fatigue since end of treatment with RCHOP & radition 2.5 yrs ago.  He mentioned a possible link to lymphoma but said not to worry....of course I wouldn't worry, NOT!  2 things I'm thinking about.  What type of lymphoma might be indicated and has the biopsy procedure changed much in the last 3 years?  My last one was very painful?  WBC is good and RBC is just under normal range.

po18guy

Sorry to hear this

I would think that the rads and R-CHOP caused this by damaging your marrow. In that case, I would think that it is more adaptation to the condition than anything else. Dr. probably wants to look for myelofibrosis, which is technically a cancer, but which causes extensieve scaring in the marrow and subsequent anemia. As serious as that sounds, a transplant will cure it. As to your overall condition, my hematocrit and hemoglobin are both constantly low. Hematocrit was in the teens at one point. Got me a free weekend and a transfusion or two out of that. There's really only one way to get some marrow out, but it should not be a horrible experience. I had one or two marrow aspirations that bothered me but all the rest were walk in-walk out, with virtually zero discomfort. You can ask for their best "aspirant" - unless your doctor will be doing it.

Gwfl

po18guy said:

Sorry to hear this

I would think that the rads and R-CHOP caused this by damaging your marrow. In that case, I would think that it is more adaptation to the condition than anything else. Dr. probably wants to look for myelofibrosis, which is technically a cancer, but which causes extensieve scaring in the marrow and subsequent anemia. As serious as that sounds, a transplant will cure it. As to your overall condition, my hematocrit and hemoglobin are both constantly low. Hematocrit was in the teens at one point. Got me a free weekend and a transfusion or two out of that. There's really only one way to get some marrow out, but it should not be a horrible experience. I had one or two marrow aspirations that bothered me but all the rest were walk in-walk out, with virtually zero discomfort. You can ask for their best "aspirant" - unless your doctor will be doing it.

Yes, I believe that's exactly

Yes, I believe that's exactly what he said, that it may be myelofibrosis and that we should check it out.  What type of transplant might be in order for myelifibrosis and he wants to do one?  I'm also taking Prolia to strengthen the bones could that be effecting my blood counts?  

Max Former Hodgkins Stage 3

Anemia

Gw, I have tested as anemic a few times since chemo ended.  The first was about four years after treatments ended, and was pretty severe.  The doc had me tested for causes related to bleeding and diet first:  a complete colonoscopy, and a celiac test, and both were negative.   For males, the GI test is usually where doctors look first.   I went on IV Iron for a period, and that resolved the issue for several years.   I tested anemic again about a year ago, but it was not as severe, and the onc put me on OTC iron supplements, but 2 a day only got me borderline normal, but she has not done anything further.

Be aware that 4 or 5 blood tests results relate to anemia; besides RBC, transferrin and transferrin saturation rate values can also help the doctor isolate a possible cause.  Any of the 'blood cancers' (lymphomas, leukemias, and multiple myeloma) can cause anemia, but hopefully it is none of the above.   Good luck with this,

Gwfl

Max Former Hodgkins Stage 3 said:

Anemia

Gw, I have tested as anemic a few times since chemo ended.  The first was about four years after treatments ended, and was pretty severe.  The doc had me tested for causes related to bleeding and diet first:  a complete colonoscopy, and a celiac test, and both were negative.   For males, the GI test is usually where doctors look first.   I went on IV Iron for a period, and that resolved the issue for several years.   I tested anemic again about a year ago, but it was not as severe, and the onc put me on OTC iron supplements, but 2 a day only got me borderline normal, but she has not done anything further.

Be aware that 4 or 5 blood tests results relate to anemia; besides RBC, transferrin and transferrin saturation rate values can also help the doctor isolate a possible cause.  Any of the 'blood cancers' (lymphomas, leukemias, and multiple myeloma) can cause anemia, but hopefully it is none of the above.   Good luck with this,

Dr. mentioned colonosopy

Dr. mentioned colonosopy visit before last but not this last visit. A fecal test was negitive.  Transferrin was low.  PET scan is next and also bone biopsy. 

po18guy

Myelofibrosis is one of the go-tos

It is an obvious choice for cause of anemia, something that is to be eliminated, not confirmed. Did you hear that? Eliminated. Should you have it (worry about today!), you have some time to decide. If you have signs of it, there is watch and wait, clinical trials. Transplant. It would have to be an allogeneic transplant, in which your marrow is ablated (destroyed) and someone else's transplanted in. Age and co-morbidites are much less of a concern that before. I'm 6 years past mine when it was not certain I would see the next morning.

BUT! None of that has occurred! How's your iron level?  

Gwfl

po18guy said:

Myelofibrosis is one of the go-tos

It is an obvious choice for cause of anemia, something that is to be eliminated, not confirmed. Did you hear that? Eliminated. Should you have it (worry about today!), you have some time to decide. If you have signs of it, there is watch and wait, clinical trials. Transplant. It would have to be an allogeneic transplant, in which your marrow is ablated (destroyed) and someone else's transplanted in. Age and co-morbidites are much less of a concern that before. I'm 6 years past mine when it was not certain I would see the next morning.

BUT! None of that has occurred! How's your iron level?  

Iron level is 119.  Iron

Iron level is 119.  Iron panel is all within range.

Max Former Hodgkins Stage 3

Gwfl said:

Iron level is 119.  Iron

Iron level is 119.  Iron panel is all within range.

Doc

Gw,

My current onc, who is a lead on clinical trials and Director of our SCT office, when I told her I had been on IV iron years ago with my previous onc, said she had seen iron levels in a few patients go to "ZERO," but they later came back.   Keep us updated

Gwfl

Update on my situation. Been

Update on my situation. Been continuing PT for some time now and feel myself getting a little stronger and balance improving. My blood work #'s that were trending down are now starting to climb back up...hope this stays a trend! Both biopsy and PET came back clear so I'm still NED!  Unfortunately I managed to have a mild heart attack recently. A stent was put in and recovery is going well. One of the benefits of a cardiac event is that it opened the door to cardio rehab at my local hospital. 12 weeks of monitored exercise and diet. I'm loving it and it will keep me busy till the end of the year and hopefully helping my shake some of the fatigue.