[Susan]

I had my first bmb in 5 years. I have PNH, in early 60s. Cellularity 25%. Fish MDS panel, cytogentics, karyotypes all negative.

Marrow is absent neutrophils (new). ANC suddenly fell from 1.1 to 200-300, had my first neupogen shot.

How worried should I be? Last (2009) bmb had zero blasts. My local hem didn't give me a dx. She just said 5 or more blasts...leukemia. But I know the blasts need to be much higher to be leukemia - correct? I know low risk MDS dx includes <5 blasts but what if everything else looks normal?

Will definitely keep on eye on this -repeat bmbs and see an MDS/leukemia expert within a couple of months, probably Mikkael Sekeres at Cleveland Clinic.