bone marrow results

Just wondering if anyone could help me on what some things on my bone marrow results mean?

Not sure, but can try. Like what? Have you asked your doctor?

Well they told me that everything was normal. But they also aren't sure what is wrong with me and when I was reading through the report I came to the section of

IMMUNOHISTOLOGY:

CD20; Positive in occasional lymphoid cells
CD3: Positive in scattered lymphoid cells

And when I looked it up it was pretty confusing so I was wondering if anyone else knew what it meant?

I tried to break it down a bit. I do know that we all have the CD20 marker on B cells(white cell, lymphocyte); those are the exact cells that Rituxan targets to try to stop the destruction of platelets. They should be there. Have you had Rituxan lately? Just curious, has nothing to do with the presence of them, although I'd think there would be less if Rituxan had been used in the last six months.


Lymphoid cell - Any of the cells that mediate the production of immunity, including lymphocytes, lymphoblasts, and plasma cells.

Lymphocytes are white cells, namely B cells and T cells.


CD20
An antigenic protein found only on the surface of B lymphocytes. It can be used to identify and separate those cells from others and can be exploited as a target for monoclonal antibody therapy.

CD3 is required for T-cell activation, drugs (often monoclonal antibodies) that target it are being investigated as immunosuppressant therapies (e.g., otelixizumab) for type 1 diabetes and other autoimmune diseases. (These are also cells that are responsible for autoimmune problems which are targeted in monoclonal antibody therapies).

As far as I know, that is all normal. If not, I would think your doctor would tell you.

CHELS04 wrote: Well they told me that everything was normal. But they also aren't sure what is wrong with me and when I was reading through the report I came to the section of

IMMUNOHISTOLOGY:

CD20; Positive in occasional lymphoid cells
CD3: Positive in scattered lymphoid cells

And when I looked it up it was pretty confusing so I was wondering if anyone else knew what it meant?

My father had a bone marrow biospy a few years ago, and I helped him with his report. As Sandi said, your report looks normal. The CD3 and CD20 cell surface proteins are normal and should be there. In fact, you want them to be there because they are important for immune function. Ultimately the docs weren't able to find anything wrong with my father other than mild anemia, which for reasons they still don't understand, has since resolved.

If you don't mind my asking, what motivated this test?

AOI,

I was still filling extreme fatigue bruising an gum bleeding at platelet counts around 100 and no one could tell me y. An they still can't I have had so many blood test and no can tell me what is wrong my neutrophils started to decrease so we opted to have the bone marrow just to be sure there wasn't anything but no one can tell me y at around 100 I still feel horrible.

Chels:

Have you been tested for general things like vitamin deficiencies, thyroid disorders, etc? Have you been on steroids lately?

CHELS04 wrote: AOI,

I was still filling extreme fatigue bruising an gum bleeding at platelet counts around 100 and no one could tell me y. An they still can't I have had so many blood test and no can tell me what is wrong my neutrophils started to decrease so we opted to have the bone marrow just to be sure there wasn't anything but no one can tell me y at around 100 I still feel horrible.

Like you, I get impressive bruising at counts around 100. It's not ITP, my docs tell me. I went through all the testing Sandi mentioned and more besides, and they still are quite certain why I bruise, though they did find lots of micronutrient deficiencies, subclinical hypothyroidism, and a few other minor things.

Are you on any medications? Do you have any diseases, disorders, or other issues? Such factors can often account for bleeding, fatigue, etc. All too often people blame their ITP for things that just aren't a part of ITP, and later find out something else was going on.

I have had my thyroid tested my counts are on the low side for that but still in range. I have also been test for iron and all that nothing comes back off. My neutrophils dropped down to 1.8 but those were coming back on my last labs. They sent me to one of the best hemo in the world and she couldn't figure it out and after they said my bone marrow was fine of course there are some things in the report that are there but it says aren't significant. I don't take any meds at all and I haven't been on steroids since November of last yr. I have been tested for lupus RA and I do have a swollen lymph node on my neck has been for over a yr they did ct scan said it was fine. I am beyond frustrated! I could sleep for days and my hair falls out like crazy my gums bleed and my bruises are nasty. I have never had a health problem ever!

it also states that my bone marrow aspirate is hypocellular and aspicular. What does that mean?

Chels:

Getting a diagnosis isn't always clear cut. Sometimes symptoms appear before the disorder can be diagnosed. It happened to me. I began to have physical symptoms of Lupus in 2005 but blood work was fine. Fatigue, feeling flu-like, muscle pain, fevers, joint pain, etc.... I was monitored every three months by a Rheumatologist who kept telling me that I was fine. I was actually happy to hear that, I didn't want anything to be wrong. He kept seeing me though and doing regular blood work. A year and a half later, my labs began to change and I got a Lupus diagnosis. That was the problem all along, but symptoms and labs do not always correspond. It's no one's fault, no one missed anything. It just sometimes goes that way. Things like connective tissue disorders can be very hard to diagnose and can take time. You may or may not be headed in that direction, but finding out what's wrong can be a long process.

Bleeding gums can be caused by a few things. Abrasive toothpastes. My gums bleed if I use a tooth paste with baking soda. Vitamin C deficiency can cause bleeding gums; try taking that for a while. Gum disease can cause bleeding gums. There could be simple explanations for some of those symptoms. Sometimes you have to separate them and research one at a time instead of lumping them all together and assuming they are related to one illness. They could all be symptoms of one, but until it develops some more, you probably won't find out what it is.

Hypocellular - less than the normal amount of cells

Spicular - The formation of new bone begins with the development of a bony matrix made up of bone spicules. These spicules are made up of networks of thin fibers with calcified deposits interwoven throughout. The fibers calcify and enclose some osteoblasts (bone-making cells) and begin to form new bone spicules. This soon forms a network onto which more layers of bone are added, eventually giving rise to a finished bone.

Chels: you really need to ask your doctor about it if you have questions. We can't interpret your bone marrow biopsy results. If they told you it was normal, it probably is normal for what they would expect to see in someone with ITP. I'm sure the doctor could explain the specifics far better than we can.

As Sandi said, a proper diagnosis often takes time, especially if you have an usual or slow presentation of a less common disorder. I went 14+ years between first major symptoms and a proper diagnosis of the spinal problems I have. So I understand your frustration.

Work with your doctors, and accept what they tell you when they say your blood work, biopsy results, or other labs are normal. We all have unusual features or variations, and with enough testing these will be found. But they are clinically insignificant, so please don't pick apart every word on your biopsy. That leads to unnecessary frustration and confusion.

At this point I'd suggest seeing your PCP and undergoing a routine physical. See if that doc can pick up on anything, from a vitamin or mineral deficiency to allergies, that can be addressed. Diet and lifestyle changes often help with fatigue and other nonspecific symptoms regardless the cause, so maybe try to improve how you feel even if you don't have a working diagnosis.