Low WBC, Low Platelets, Low RBC, Large cells - is it always Leukemia?

@asarnesejr You are on a rollercoaster! Those are vastly different diagnoses. You wondered why you had varying CBC results. I am not a Dr, but my results have varied especially if I was sick and possibly on other meds. A Dr can tell you why the variations. I do not understand the different diagnoses. The counts you posted originally were like a mirror of my own at different points. What did the FISH results show. It is important that you see a Hematologist who is also an Oncologist. If you can be seen by a a Hem/Onc at an MDS Center of Excellence that's even better. Did the 2nd Dr see the results of the BMB? Hem/Oncs don't pursue a BMB unless there is cause. Centers of Excellence: https://www.mds-foundation.org/community/centers-of-excellence/browse/?country=US

hi again. Both doctors are Hematologist/Oncologist. Just two different hospitals.

To recap: initial routine blood test: B12 153, WBC 1.6, ANC .6, MCV 106, Platelets 65.
No blast cells in red blood, 2% blast cells in bone marrow, large red blood cells in bone marrow. FISH results were negative. No symptoms, feel fine.

Doctor #1: B12 is not low enough to cause these issues. Is either Leukemia or MDS. Bone Marrow Biopsy next morning. After 3 weekly B12 injections (from my primary doctor) he concluded low-risk MDS (before my FISH results were returned). Ordered 6 weekly blood CBC blood tests.

Doctor #2: B12 is low enough to mimic the MDS symptoms. 3-weeks of weekly B12 injections are not enough. Stopped weekly blood tests. Weekly blood samples could lower my hemoglobin levels. He is Skeptical of the Diagnosis. Ordered me for 6 more weeks of weekly B12 injections, no blood tests till September 16th.

What are your thoughts on all of this? Will I know on the 16th if it's cancer or just B12 issue?

Hi again - I'm the 60 year old that got diagnosed with low-risk MDS recently in August.

I went for a 2nd opinion at another hospital, and the Hematologist there felt that 3 weeks of B12 injections (153) was not enough to rule out a vitamin B12 deficiency. He felt low B12 could mimic my low WBC, ANC, large Red Cells, and lower Platelet counts. He is recommending that I go for a full 8-weeks on weekly B12 injections and see how my body responds. In his words, he is 'skeptical of the diagnosis'.

Does anyone have any thoughts to this? This emotional rollercoaster is putting me into a state of panic and depression. Now I have to wait till September 16th to find out if I have a life altering MDS or a B12 deficency.

So sorry you have this going on. In my experience, low B12, as well as other factors can drive these numbers. I've had it happen, and turned out to be OK. Of course, they can always do a bone marrow biopsy to be sure, not the pleasant way to find out. But if they aren't seeing blast, they likely are thinking it isn't our old friend leukemia in some form. Best of luck!

Hi again - I'm the 60 year old that got diagnosed with low-risk MDS recently in August.

I went for a 2nd opinion at another hospital, and the Hematologist there felt that 3 weeks of B12 injections (153) was not enough to rule out a vitamin B12 deficiency. He felt low B12 could mimic my low WBC, ANC, large Red Cells, and lower Platelet counts. He is recommending that I go for a full 8-weeks on weekly B12 injections and see how my body responds. In his words, he is 'skeptical of the diagnosis'.

Does anyone have any thoughts to this? This emotional rollercoaster is putting me into a state of panic and depression. Now I have to wait till September 16th to find out if I have a life altering MDS or a B12 deficency.

I would like to know if there is a link I have the same let me know

I've had a bone marrow biopsy and the only thing they found was some larger red blood cells in the marrow. Dr 2 says that B12 deficiency can mimic that as well. Bone blasts were 2% and zero bone blasts in the blood. FISH results were normal

oh, Hemoglobin is 13.6, RBC 3.88

I'm not sure what you're trying to say.

I think steveduke is saying that the people on this forum are not doctors and you should listen to doctors you trust. If you are skeptical of the first two opinions you can get a third one. My hematologist is a researcher who studies my disease and I don’t especially like him but I trust him. My hemoglobin has been as low as 8.5, currently 11, and I sometimes have blasts and sometimes not. Your numbers will change from time to time and you shouldn’t panic at the slightest change. I have had CMML and myelofibrosis for ten years and I’m doing fine. Blood cancers are not an automatic death sentence. Find a hemotogist/oncologist who specializes in your disease and do what they say. Don’t panic, because there are worse things you could have. I consider myself lucky when I see young women with small children with ports for chemo and no hair. You can go on for a lot of years if you find the right doctor and treatment.