Dear Dr. David,
Thank-you for your response. Just a little more information for you: we do visit the doctor for serial cbc's. Also, the main concern I had with these 2 numbers standing as they are is the fact that almost every reason they would be this way is either because it's turning into leukemia or some other worse reason that I'm pretty sure my son doesn't have, like liver failure. His hematologist still seems to think that his MCV is high due to lack of B12/folic acid...which is impossible because he takes like 4x the normal dose of those (under doctor's supervision of course.) His MCV is actually the lowest it's been in over a year & his history with low MPV always correlated before with the need for a transfusion, which he obviously does not need now in platelets.
I'm just wondering if he's a ticking time bomb and the doctor just doesn't want to point these issues out to me because he's doing so well. SO, just to quench my thirst for knowledge, IF there is a hematologist who can give me a more in depth answer, I'd prefer if you opt-out. I'm a very medically minded woman due to being brought up by a doctor-father, so I need complete answers. Not that I'm worried, as I know relapse could always occur, and I'm ready for it when it does, but I just like to know the "whys." Thank-you so much for your time & your concern. God bless.
Is there a way to either close this question without hurting your 100% feedback or will I be getting a different doctor's opinion soon? Thanks for your help.
Hi Dr. Louise,
So, what if the MCV has been high since 10-1-07 and this is the lowest it's been? The other hematologist who worked with my son's doctor suspected Fanconi's anemia because his MCV was so high & never lowered (I believe it was always over 100 before this past couple months). Now that we know it is aplastic anemia, how long should I accept an elevated MCV before requesting another bone marrow biopsy? I know his doctor is frustrated with this number because she keeps trying to put her finger on why it's still high...which is why we've continued upping the dose of his B12/folic acid, but it hasn't really changed much. What other issues do you look for with an elevated MCV?
Thank-you for your insight!
Hello Dr. Louise,
Yes, Fanconi's has absolutely been ruled out as his breakage test was completely normal & no abnormal body parts could be found. Josef is not on any drugs at this time, only herbs & vitamins, all of which have been approved by his hematologist as not interrupting anything she's done. The last time he was on septra was I believe in January '09.
His most recent bone marrow test showed: 80% cellularity, blasts are not increased, lymphoid gate, 13%, kappa/CD19, 7%, lambda/CD19, 5%, CD5/CD19, 4%, CD20, 13%, CD10, 15%, CD19, 27%, CD5, 49%, CD19/CD10, 16%, TdT, 4% (scattered positive cells). Flow cytometric analysis shows a small population of CD19/CD10 positive cells present.
His doc had mentioned a while back that his marrow showed more of a possibility to morph into a different disease like leukemia based on some of the percentages she saw. Does this ring true to you? Thanks again.