New ITP diagnosis..question about Bone Marrow Biop

Hello, I was diagnosed with ITP after being admitted to the hospital with an uncontrollable bleeding nose on April 2, 2012. My platelet count was 2.1K. After receiving IVIG, IV Prednisone, which was converted to PO after discharge from the hospital,my plt count rose to 100K. The following week it was 297K, then the following week it dropped to 36K, and finally 29K at which point I received round 2 of IVIG. I got a rise to 207K last week and now this morning it is 86K. Needless to say I am starting to see the trend and expect it to drop again next week. I am nearly weaned off of Prednisone which is not working for me as you can see by my numbers. My Hematologist is talking about doing a Bone Marrow Biopsy next and of course the subject of Spleenectomy has come up more than once in our conversations. I know everyone is different and ITP is highly individualized, but I am wondering what the opinion is here on the BMBX question? I also just read for the first time about a drug mentioned here called N-Plate. Any information would be very much welcomed. Thank you so much for this site and the wonderful information found here. Rose

Rose:

A bone marrow biopsy is not necessary for an ITP diagnosis, but it can give peace of mind. It is usually recommended if the patient is over 60 or if a splenectomy is being considered. It's not as bad as it sounds (wasn't for me). It took about 20 minutes in the doctors office and I was okay for work the next day.

I suggest you read this if you haven't already. It will avoid some confusion if your doctor tells you that you are producing plenty of platelets:

www.pdsa.org/forum/6-general-itp-discussion/11698-bone-marrow-biopsy-and-production-answers.html

N-Plate has been used by a few of our members, some for several years. It can be a good treatment in certain situations. Keep in mind that it is a maintenance treatment.

Sandi, Thank You so much for your response. I am blessed that I have a medical background and work at a nationally known medical center, although I am not being treated at my work location.I am very familiar with bone marrow biopsies and not worried about the pain part of it.It is interesting that not all ITP patients require this procedure. With my platelet count of 86K this week, my Doctor is going to wait until next week to see what the number is before the next treatment. Likely that will be round 3 of IVIG if I drop below 30K. I am so happy to have found this site as I feel it is a place to get answers beyond what I have access to. Again thank you so much, Rose

It's pretty much protocol NOT to give a BMB, unless the reasons I stated above are applicable. However, some doctors still do it anyway. It used to be more common than it is now.

I'm glad you know a bit about it ~ that will sure help!

HI ROSE, I JUST RECENTLY HAD A BONE MARROW BIO, IT WILL NOT HURT,IT IS A TOOL TO SEE IF THERE OTHER CAUSES OF ITP. THE DATE OF MY BONE MARROW TEST WAS MAY 26, 2012 , I DIDNOT GET THE RESULTS OF IT AS OF TODAY JUNE 3. DO SOME RESEARCH IF YOU HAVE A COMPUTER, DO A SEARCH ON VARIOUS DRUG TREATMENTS, AND SIDE EFFECTS,,EVERY ONE RESPONDS TO MEDICATION DIFFERENTLY. I WISH YOU WELL. TAKE CARE. FRANKIE