Pathology/Bone Marrow Pathology Report
Husband 58 has been very tired, aching joints, and dizzy/blackouts. He drives tractor trailer but has done own mechanics involving use of paint thinners, gasoline to clean parts,& inhaled diesel fumes for 40 years. Blood work showed Iron over 900 and low RBC, WBC, & HGB: told was Iron overload anemia. Bone Marrow biopsy done and Hypercelluar Bone Marrow with 70% w/Mild Trilineage Dyspoesis; abnormal localization of immature precursors. Megakaryocytes present in normal #s/with few small hypolobated forms noted and rare circulating immature megakaryocyte is seen. Granulocytic matruaration shows rare Pelger Heutt form & some cells contain hypogranular cytoplasm. Erythroid lineage shows cells w/pyknotic, karyorrhetic nuclei; some cells intense cytoplasmic basophilia. Megalobastoid forms are seen w/open chromatin pattern. Myeloid-erthroid ratio 1.8 : 1. Report stated refractory anemia (low grade MDS). Do you agree with diagnosis? Dr has advised that there is no treatment at this stage other than ones that the side effects are as much problem as disorder, but am concerned about damage to joints from iron overload. Also because his MDS could be related to benezene exposure does he not need treatment plan?
As per the description provided by you the diagnosis fits in with MDS with refractory anemia. This is a disease in which the bone marrow does not produce healthy blood cells.
At this stage only supportive therapy is given - to correct anemia and iron overload even if the caus of the disease is benzene exposure. If immature cells were present then chemotherapy would be better.