Hello doctor, I am 40 years old. 20 years back I was diagnosed with Severe Aplastic Anemia (idiopathic), which was treated with ATG (With Prednisone/Cyclosporine). It took a good year to have a complete recovery, but it came back to 100 %. I have always lived a bit in the fear of Myelodysplasia, but 23 years later no issues other than cholesterol and high blood pressure. I am being follow by a family doctor and getting blood counts every 6 month, but my last hematologist consultation was a very long time ago and while my doctor is fantastic, I know that knowledge of hematology is complex. I am tracking by blood counts for the last 12 years. In the last 2 years, I develop my own concerns around some numbers that seems to trend on lower side. First is erythrocyte, which are 4.3 now. 13 years back I was consistently around 4.8, but my last blood count was 4.3. But after 5 years, it has never been above 4.5. I do not know if this is significant or not. But I know that our reference is 4.7 of the lower value. Average (13 bloods test) would be 4.53. My hemoglobin is at 132 now. My average would be 141, so the difference is not high, but I still wonder about if it is significant. Finally, Hematrocrit at 0.4, right under the low-level . It would average out a 0.41. Now a new contender appeared in the outside of normal ranges, and its the Granulocytes # (Immature) at 0.04 (reference is 0 - 0.03 10e9/L). Platelet are doing great with 183, so no challenges here. So in a way, all of these number are very close to the lower normal. I guess I am trying to figure out if I should investigate this further. I will see my doctor in a few weeks for a follow-up, but in our last appointment she did not see any issues there. In a way, I get her point but I am not sure when I should start asking for an hematologist reference. As for current medication, I am on Rosuvastatin (20mg), Ibersartan (300mg) for a few years already. But new to me is Allopurinol (200mg for now; still working on balance). My question is really about if the number above can indicate a trend, or not. I understand the body change as we are getting older, but I would like some opinion on this.
Hi. I reviewed all the documents you attached (attachment removed to protect ptient identity). I can feel your concern as I have closely followed many aplastic patients before. So, the fear or concern you have is genuine but I am happy to say that your CBC is wonderful. I am not bothered at all. The slight decline may be due to other reasons, sometimes diet, nutrition, laboratory variation, etc. I would advise you not to worry and just get a routine laboratory check as per your primary physician like 6 monthy or so. You completely recovered.  The only advice is to make sure when you start any new drug or take OTC drugs/ herbal medications, make sure they do not have side effects of bone marrow suppression. So, just be cautious. Rest you are doing good.Please text me any other concerns if you have.