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What Does The Following Blood Test Report Indicate?

Posted on Sat, 11 Jul 2015

Question: Hello, My dad had Haemoglobin count 8 and diagnosed with additional material on 4q35 chromosome. Doctor advised to take Darbepoetin Alfa Injection for 4 weeks and now Haemoglobin count has increased to 9.6 after 20 days.
Now, Haemoglobin is 9.6, RBC is 3.0, WBC is 8700, Polymorphs is 32, Lymphocytes is 60, Eosinophil is 05, Monocyte is 03, Basophile is 00, PCV is 31.4, MCV is 104, MCH is 31.9, MCHC is 30.5, Platelet count is 142000. Kindly let me know your comments and do I need to worry anything? He is 62 years old XXXXXXX

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Anemia

Detailed Answer:
Hello

Thanks for the query

It looks like your father's bone marrow has decreased ability to produce red blood cells. This explains why there is anemia ( low hemoglobin), neutrophils and platelets.
There is a cause for concern as this leads to more susceptibility to infections and also weaker heart.
Here is how you should go about it

1. I recommend you to follow strict hygiene in the form of cutting of nails regularly, clean hands and personal hygiene.
2. Be on regular follow up with your physician
3. Darbopoetin is an excellent drug for increasing hemoglobin. PLease continue to take it. But please make sure that his iron stores are normal or else the injection will not be effective. Serum iron stores, T saturation and Serum ferritin needs to be checked once in three months.
4. I recommend you to meet Dr XXXXXXX of M S Ramaiah Hospital, XXXXXXX if feasible. He is an excellent hematologist trained in Toronto, Canada

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rakesh Madhyastha (49 minutes later)

Hello Doctor,

Thanks for your reply.
Any concern of Acute Lukemia, MDS or any major disease? The additional material on 4q35 implies to what? Do we have to continue taking Darbepoetin and based on what we can stop this medicine? Could you please suggest any cheap darbepoetin medicines?

Thanks and looking forward to your immediate response.

Many thanks, XXXXXXX

Answered by Dr. Rakesh Madhyastha (17 hours later)

Brief Answer:
follow up

Detailed Answer:
Hello

Thanks for getting back

Since there are several questions I will answer them one by one

1. It does not look like leukaemia however mds is a possibility
2. The extra bit on the chromosome might be contributing to his present condition
3. You will have continue darbepoetin until the hemoglobin reaches 11
4. Erythropoetin is cheaper, please ask your consultant for dealers number, they will give it for cheap

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (7 hours later)

Hello Doctor,
Thanks for the detailed explanation. I have consulted a hemotologist and she advised for PNH workup- flow cytometry CFLAER test (CD55 and CD59). I have approached a lab and they told they have PNH panel which has CD55, CD58, CD59 and CD33. Is it the same doctor had prescribed? Do you feel that doing this test is really required? This hemotologist also confirmed that this can be low level MDS. Please advise us at your earliest convenience. I am not sure where PNH will be done.

Thanks, XXXXXXX

Answered by Dr. Rakesh Madhyastha (14 hours later)

Brief Answer:
Mds

Detailed Answer:
Hello

It is the same 'cd' but please make sure that the method they are using is flocytometry if not XXXXXXX diagnostic laboratory and Ttk blood bank in XXXXXXX does it. You can call them and find out how to send the sample to them.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar