My mom is not well from last 1 month or so. She is under medication and yesterday as per doctor advice we have do a bone marrow test. Need your help in understanding the report and the treatment if any to cure her. Bone marrow report details are peripheral blood smears: total leukocytes count is within normal limits. Differential leukocytes count shows neutrophilia predominance. Platelet count is markedly diminished. Erythrocytes are normoochromin normocytic. Anisocytosis present. Comments: bone marrow smears reveal megaloblastic and dysplastic changes, and increased storage iron. Please exclude systemic disease, and deficiency of vitamin b12 and folate, and follow up. In absence of above condition, the possibility of myelodysplastic syndrome should be considered, if cytopenia persists. Report on bone marrow: clinical history: bicytopenia with low grade fever. Cellularity: cellular marrow bits and cell trails seen. erythropoietin: a significant number of erythroblasts show megaloblastic and dysplastic changes. Myelopoiesis: myeloid maturation is mildly left shifted. Giant myeloid precursors and a few dysplastic myeloid cells seen. Myeloid-erythroid ratio: 2: 1 megakaryocytes: megakaryocytes are adequate in number. A fair number of meagkaryocytes are hyperlobulated. Plasma cells, lymphoid cells & blast cells: within normal limits haemoparasite: none seen perl's stain: stainable storage iron is increased. No ring sideroblast seen. Need your guidance and opinion.
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Firstly, it has been recommended to check for vitamin b12 defficiency and other diseases if she has already. For this vitamin b12 level should be tested in blood. If these two points are okay, then she will be diagnosed as having myelodysplastic syndrome. Mds are conditions that occur when the blood forming cells in the bone marrow are abnormal. It is considered as a type of cancer. So better not to delay and start the treatment. The treatment plan consists of supportive care, drug therapy and chemotherapy with stem cell transplantation. In supportive care, transfusion therapy, erythropoiesis stimulating agents and antibiotic therapy is done.
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