@steveutnv I had the bone marrow biopsy and aspiration, genetic/hereditary blood work, spleen, kidney. liver, thyroid checked and all good. Mine went from 70 to 92 the day of the bone marrow biopsy and stayed there for 2 months. Next check was 58. There is no cause for mine either which is pretty frustrating. Did they put you on any type of med when it fell before 50? I go back the end of the month and if below 50 that is what the hematologist wants to talk about. I am almost 72 and she said there are not many options, and I won't do steroids. Hope your biopsy was all clear. I am also wondering why they waited so long to do the biopsy - 10 years is a long time!