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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
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Experience:  14 years as clinician in the field of Family Practice
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I am writing because recently I had a bone marrow biopsy

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I am writing because recently I had a bone marrow biopsy performed. The results only showed the following:
-Marrow Hypercellularity with trilineage maturation. Hypercellular approx 80%
-Absent Iron stores
The comment section reads:
There are no features suggestive of a myeloproliferative or myelodysplastic disorder. This could represent compensatory marrow hyperplasia.
My WBC has been between 13K-17K with Lymphocytes>5,000. The myeloid to erythroid ratio is normal to mildly increased. (about 4:1) The myeloid series shows maturation to the segmentd neutrophil stage with no apparent dysplasia. Megakaryocytes are increased in absolute numbers but are otherwise normal in morphology and distribution. There is no increase in blasts. No lymphoid aggregates or granulomas are seen. Iron stains show no stainable Iron.
My oncologist has said that I don't need to see him but I am feeling terrible. Tired, fatigued and generally unwell. Iron studies show that I am borderline anemic. I consulted with a GI specialist and he performed a colonoscopy as well as endoscopy and did not see anything that could be causing anemia. I have more ifnormation should you need it. My oncologist told me that I don't need to see him unless my WBC exceeds 20K. The scary part is that I have tested at 17,300. I have no infection or illness that would be causing the WBC to be high. The WBC count has been elevated (above 12K) for at lease 3-4 years that I know of. Thats as far back as my tests go. Please let me know your thoughts. Thanks Wes.
Anthony Bray, MD : Hello!
Anthony Bray, MD : your results sound more reassuring than not but I understand your basis of concern...
Anthony Bray, MD : The bone marrow biopsy showed no sign of malignant change which is good of course but I understand that this still leaves you wondering why your white counts have been running high...
Anthony Bray, MD : It would seem to raise concern with the hypercellularity of the marrow BUT the apparent balance among the cell lines -- platelets ( from megakarocytes) and red cell lines and white cell lines all seem to be in high production...
Anthony Bray, MD : It is reassuring that the marrow was not appearing consistent with a myelodysplastic disorder or myeloproliferative disorder ...
Anthony Bray, MD : this
Anthony Bray, MD : This means of course that they were examining for signs of leukemia or premalignant type changes and did not find any such pattern...
Anthony Bray, MD : your high blood counts may be a factor unique to you... It could relate to hormonal influences of these blood cell production stimulation...
Anthony Bray, MD : I do think that you should treat the iron deficiency with supplemental iron and plan periodic follow up of your CBC( complete blood count) I would favor every six months to check on that or as directed by the oncologist...
Anthony Bray, MD : I understand that your results leave you with a certain uneasy feeling but rather you really should be relieved !!
Anthony Bray, MD : I would advise taki g an iron supplement of ferrous sulfate 325mg/ day and take with vitamin C 500 mg to improve absorption...
Anthony Bray, MD : I hope that this is helpful! Let me know if you have further questions or discussion! I will be happy to get back with you !
Anthony Bray, MD : if my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated! Thank you and best regards,
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