Quote:
Originally Posted by edithr
Hopeful, this is where I get really confused. His initial values were:
wbc 0.7
rbc 9.0
neuts < 500
Platelets 38,000
They did the bone marrow biopsy and it was < 20% cellularity, so they classified him as severe. They did not do ATG for about 5 weeks, and in that time his counts rose to generally:
wbc 2.0
rbc 9.0
neuts 800
platelets 80,000
They did another BMB just before the ATG, and it was "slightly less" than before. His counts are just above those numbers now, but it is too soon for an ATG response. His only transfusion was just before the initial BMB.
So why is he still classified as severe? It seems to be based solely on his BMB.
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The criteria for severe aplastic anemia are two of the three in a hypocellular marrow:
* Absolute neutrophil count less than 500
* Platelets less than 20k
* Absolute reticulocyte count less than 60,000 /uL
It's interesting that his marrow had such a big recovery before they did the ATG. I agree, he seems to be more moderate than severe, based on the above criteria.
As an aside, I was told that my counts would improve before I saw an increase in my bone marrow cellularity. That proved true for me.