Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Sir,
Welcome to HCM.
Thank you for the query.

I did review your concern. The bone marrow report shows involvement by Lymphoma. There are various kinds of Lymphomas and from the morphology described in the report it seems like a Large cell lymphoma. Also since the wbc count is low and hemoglobin is low, it reveals systemic involvement. Fortunately the Megakaryocytes are adequately in number as of now making the platelet production possible in decent numbers.

The best strategy in this case is to first do an Immunohistochemistry including if possible Flow cytometry to determine what type of large cell lymphoma it is first of which is to know whether it is T cell or B cell.One must also determine the extent of lymph node involvement by performing a lymph node biopsy if enlarged. Many lymphomas respond well to chemotherapy but first accurate diagnosis is must. Also you will need blood transfusions initially for maintaining hemoglobin above 8 and also platelets if needed.

As far as XXXXXXX is concerned I would recommend Dr XXXXXXX Shah of XXXXXXX Hemonco clinic. However if you plan to get managed at other place then Tata memorial cancer center at XXXXXXX is also a good place for treatment.

I hope this helps.
Let me know if you have any other questions or concerns sir.
Wish you all the best.
Sincerely,
Dr Parth XXXXXXX Desai

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Brief Answer:
Dear Sir. I am specialist Hematologist and Oncologist.

Detailed Answer:
Dear Sir,
Thank you for your reply query.

I am a practicing Hematologist. After looking at the report, My recommendations would be just as above. For proper treatment of the condition a accurate diagnosis is must. For large cell lymphomas first of all one must know whether it is B cell or T cell. For B cell large cell lymphomas, Rituximab-CHOP or Rituximab-EPOCH based therapy is the best combination. For T cell lymphomas Vorinostat-CHOP based therapies are recommended. Along with this supportive therapy in form of repeated blood transfusions may also be necessary due to low hemoglobin.
However, Since I do not practice in XXXXXXX and am currently in MD XXXXXXX Cancer Center XXXXXXX USA I suggested the name of the doctor I believe will provide specialized treatment and support.

Let me know if you have any other questions or concerns sir.
Wish you all the best.
Sincerely,
Dr Parth XXXXXXX Desai

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