bone marrow aspiration

[sarah]

Today Charlie had bone marrow biopsy, but Dr was unable to get a aspiration, he stated too many packed cells. What does this mean, I am confused?

[Neil]

Hi Sarah,
A very unusual situation.
Did the doc mention anything about hypocellular marrow?
Did they get anything at all when aspirated?
Am also confused by the “too many packed cells”. Would ask for a more specific comment.
Perhaps they meant the packed cells were clones (that were abnormal)—but that would have led to some further conclusions/comments.
Neil

[sarah]

Hi Neil, he stated he got nothing when aspirated. Something about cellularity being at 95%? All his notes state hybercellular. What is a dry tap? Also his spleen has doubled in size. Dr feels this is possibly cause of his weight loss and low RBC counts. Plans to refer us to surgeon for removal of spleen. He will have results of bone marrow biospy on Monday, which will tell us the blasts in marrow.

[lescolb]

Hi – Thanks for the note. All of my bone marrow aspirations have been “dry”. In my case, the Doc explained that the cells are so tightly packed in the marrow that they are like cement and they cannot aspirate anything – kind of like when you are having a venopuncture and the tech misses the vein
– the tissue there will not come out of the needle. It is frustrating , and rather counter-intuitive that a packed marrow (hypercellular) will not yield a specimen – you’d think that the cells would pop out without any suction on the syringe – but I guess this is not so.

I cannot make any claims about what is happening with your husband’s aspirate – keep asking additional questions until you get an explanation.
(at times I still scratch my head and wonder if the explanation I’ve been
given- and mostly accept – is not just double talk).

The docs do the best they can though. Was to the office yesterday – and we discussed sternal aspiration – and the possibility of an “Open hip biopsy”
with the orthopedic surgeon to make a much larger hole in the hip bone and actually dig out a specimen. Please remember that this has been going on for 6 1/2 years with me – and this solution may be rather drastic. Without the sample of cells from the marrow, they do not have any material on which to do the Chromosomal studies, look at the precursor cells _ and determine if there are any ringed sideroblasts, excess blasts or flakey platelet and white cell precursors. At present the only effect is severe anemia – although the platelets are very small, there are plenty of them.

Take care – hope this helps you understand more.

[sarah]

Leslie, thanks for your information. What classification are you?

[Terri]

Sarah, Sorry to hear the news, I know when Bob was first dx his spleen was considerably enlarged thats when they put him on the Hydroxurea(Spelling??) for awhile. Not sure what made the spleen go do but eventually it did.
Bob has had the problem with dry aspiration but somehow the doctor moved the needle around some and got enough out (I am so glad I am not in the room I could not imagine him moving that needle around to find fluid). Bob says he is excellent however and he never feels pain.
I hope Things start looking up for Charlie

[lescolb]

Hi Sara – long delay I know – at present the diagnosis is MDS, RA. However, without a look at the marrow, they really cannot tell re: excess blasts, sideroblasts, chromosome abnormalities. I am going to Phila on Monday for another try. They will be sedating/anesthatizing me and I am not sure what the docs will try, there was some talk about a surgical biopsy. Guess they will discuss that on Monday prior to the procedure. Wish me luck!!

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