Oncology (General Cancer)/blood morphology


an alpha-thalassemia silent carrier. I am in my first trimester of pregnancy and the CBC says my HB count is 11.0 (RDW 15.4, MCH 23, MCHC 32, mcv 73) and WBC was 12THP/ul (Though normally my WBC remains around 5). My RBC morphology says there are tear drop cell present and Echinocytes present. My doctor said these abnormal cells are due to my Thallasemia.

But I read on Internet that Tear drop cells generally present in major Thalassemia, severe iron defficiency and Myelofibrosis. But my question is, If I dont't have major thalassemia and HB level is also not that low, Is there a possibility that I have Myelofibrosis ?

I've seen tear-drop cells in patients like you, from the thalassemia.  You are not "silent", because you have altered red cell indices and morphology.  You also may have a little iron deficiency which can occur in women who are pregnant, and if you were my patient I'd check you for that.  Even if you are taking oral iron, some people can't absorb it very well.  As for myelofibrosis, I strongly doubt you would get it agt your current age, assuming you are in your twenties or early thirties.  The slight elevation in white cell count is probably pregnancy related but could be due to iron deficiency as well.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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America's Best Physicians, last 14 years

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