Disease Progression- Occasional Blasts in Peripheral Smears

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• March 2, 2022 at 2:19 pm #57459
  Karen Scerbo

  Participant

  Good afternoon all,

  It’s been a while since I posted with regards to my mom’s MDS diagnosis in July 2019. Happy to say she is here, still receiving monthly blood transfusions, (now it’s bi-weekly due to the US blood shortage; they are only giving her one unit provided she is above 7.0 upon discharge). She receives at-home blood draws/weekly cbc’s. In December 2021, her cbc peripheral blood smear showed blasts (2.0 was the reference range) and myelocytes. In the weeks that followed, her peripheral smears did NOT show any blasts myelocytes etc. Last week however, the blasts show up again on the peripheral smear, 2.0 with myelocytes 4.0. A BMB is not possible due to her bed-ridden condition, she has extreme pain in her extremities and is completely non-ambulatory. Can anyone give me insight into the appearance of blasts on the peripheral smear? Is any sign of blasts an indication of disease progression or as her oncologist said, he looks for consistency and trends so he’s not ready to commit to re-staging her MDS. FYI her platelets rebounded from 25,000 to 101,000 holding steady for over a year without medication!

  March 2, 2022 at 8:06 pm #57461
  Michael

  Participant

  Generally blasts in the peripheral blood is not a good sign. But it was explained to me by my oncologist that an occasional but not consistent appearance should not cause concern. Having said that I note that I am low risk on watch and wait for 6 yrs. I am 69 yrs. old. I also have occasional myleocytes. My sole cytopenia is neutropenia, rbc is consistently low normal, hemoglobin around 12.5 and platelets in the normal range.

  I get monthly blood draws and they have been consistent with only deviance in wbc which rises to low 3’s when I have a skin infection. It is normally in the 1.5 range. I call myself Mr. Boring. I get annual BMB’s with 1% blasts in my bone marrow.

  March 3, 2022 at 7:25 am #57472
  Karen Scerbo

  Participant

  Thank you Michael!

  I am very relieved that the blasts do occur occasionally, your oncologist echoed what my mom’s did. I really adore the doctor and trust him implicitly. Unless he is 120% sure he will not commit to a prognosis/diagnosis(such as disease progression) He told me the only indicator would be a bmb but obviously that cant be done, so he too, relies on trends and consistency and he refuses to worry me, needlessly. You gave the me second opinion I was looking for! I hope your numbers remain stable and on the watch and wait for many years! Mr. Boring is a good title. My best regards !

  Karen

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