See, I told you I was sick ...

     

Here's a bone marrow sample from an ET patient. Notice
that the megakaryocytes are more numerous, bigger and 
have nuclei that may be spread out in an irregular pattern.

Lots of ET patients complain that well-meaning friends and family tell them that they don't LOOK sick. That's because they're not looking in the right place. For us, all the abnormality is in the bone marrow.

Your blood cells, are manufactured in your bone marrow, and large cells called megakaryocytes are the "parents" of your platelets. Those are the cells that help doctors confirm that you have ET.

I found some cool slides that illustrate an ET bone marrow sample looks like under a microscope. There's one at left!

In someone with ET, the megakaryocytes (the big round purple cells) are extra big because they forget to stop dividing. In addition, the dark center of the cell (nucleus), which should look round and compact, has an irregular shape.

In an ET patient, all the other blood cells in your bone marrow generally look normal in appearance and number.

Dr. Wendy Erber talks a lot more about what doctors can see in bone marrow tests in a recent talk to a MPN Advocacy & Education conference in Australia. She explains what happens in a bone marrow biopsy and aspiration and what doctors look for in the samples taken. She recommends bone marrow aspiration and biopsy for ET patients at the outset to establish a baseline measure of what your bone marrow looks like. Any change for the better would indicate that your chemo is working. Changes for the worse might alert doctors to disease progression.

The video is interesting, humorous at times, and I highly recommend viewing it. You'll learn some keen new medical terms like these (remember that Dr. Erber is Australian, and you'll see English, not American, spellings for some terms):

Aspirate and trephine. These are two types of samples taken during a bone marrow procedure. Aspirate is the material that is sucked out of the bone marrow. Trephine is a cross section or core that is taken of the marrow and bone. (Think of trephine as something like those ice cores scientists take from antarctic ice.)

Posterior superior ileac crest. The part of your hip bone from which doctors usually take a bone marrow sample.

Hemopoesis. Blood production in the bone marrow.

Reticulum. Scar tissue that forms in the bone marrow as MPNs progress toward myelofibrosis.

Osteomyelosclerosis. When bone grows in the bone marrow area, crowding the area where bone marrow can produce blood cells.

Bizarrely hyperlobated nucleus. The abnormal appearance of the centers of megakaryocytes.

Bone marrow biopsies can be a little uncomfortable, but they are nothing to fear. You can read about mine here.

Be well!

Home