Question:I am 26 years old and was recently hospitalized for an infection and
while I was in the hospital, an MRI was done of my spine. In it, they
found that my bone marrow was "more promiment" that they would have
expected. Subsequent blood work showed that I was anemic (which was
thought to be a sympton of the infection), but all my other levels
were normal, except for my platelets which were slightly elevated, but
nothing that would cause alarm. I just had bloodwork done again, and
the anemia is almost completely gone and all my other levels remain
normal.
A radiologist examined my MRI further because I have spina bifida,
so they thought the abnormality might simply be a symptom of added
stress to my spine given scoliosis. The radiologist said that it is
typical to see sections of the spine that are more active than others,
but in my case, the entire spine was showing increased activity. My
hematologist gave my a full physical exam and says that nothing would
lead them to believe that I have any type of cancer, but she still
wants me to get a bone marrow biopsy.
I've asked what other possible disorders I might have, and she was
vague. From the online research I've done, thrombocythemia looks like
a possibility. Is this a fatal disorder? For those who know
something about blood cancers, how likely is it for all my blood work
to come back normal, but still possibly have cancer? I'm freaking
out, partly because I can't find enough information and partly because
what I am reading makes it seem that even if it is NOT cancer, other
disorders might be just as deadly.
I have a huge pressure wound that is still healing, and another wound
that kept healing and opening up again for the past two years (which
interestinlgy completely healed up just before I was admitted to the
hospital a few week, has stayed healed, and I've noticed that some
swelling and scar tissue has completely disappeared. My hematologist
says, I would NOT be healing if I had leukemia.
Answer:Platelet counts can go up as part of your body's reaction to
acute physical stress, such as your pressure wounds. They also rise
with iron deficiency anemia. It is reassuring that your anemia has
corrected itself, and I tend to agree with your hematologist that if
you had leukemia, it would be unlikely that the blood count and sores
would be getting better.
Bone marrow signal changes are frequently seen with nearby arthritis,
and seem to correlate better with the presence of pain than just
X-rays (at least with osteoarthritis of the knees).
It might be reasonable to reduce the stress on the involved area for a
period of time and repeat the MRI, do serial blood counts to be sure
they remain okay and the platelet count normalizes (especiailly if
further tests show iron deficiency, even without anemia), do a protein
immunofixation to look for abnormal plasma cell activity, and make
sure that you don't have infection in the bone with other scans.
These are all options that you could discuss with your doctor and see
why or why not they would help in your particular circumstances.
If worse comes to worse, a bone marrow test isn't bad at all, and can
be done under "conscious sedation" to further minimize discomfort.
