Low WBC months after chemo. Do I need a bone marrow biopsy ?

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robsp
robsp Member Posts: 50
edited November 2014 in Stage II Breast Cancer

After 4 months of my chemo, 2 months after radiation and 2 months of tamoxifen my WBC is around 2.1 (normal is above 3.7), my neutrophil count is 0.9 , normal is above 1.7. My Red blood count is recovering well and is now almost normal.

Unfortunately my doctors did not required blood count during and right after radiation and now I do not know if my low blood count is due tamoxifen (rare side effect) or a late side effect of chemo+radiation.

My MO is suggesting a bone marrow biopsy, but I´m not sure if is too early to evaluate my bone marrow, I am afraid of possible false positives and I little exhausted after a year of treatments (surgery, chemo, radiation and tamoxifen). I feel no symptoms and although my  WBC is low , but is not in down trend according with my exams. 

Anyone has similar problem ?  When your doctors asked for bone marrow biopsy? 

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  • coraleliz
    coraleliz Member Posts: 1,523
    edited September 2014

    bump. My white count has been running low. It was 3.0, then 2.9. I had radiation(bilateral), on Tamoxifen but did not have chemo. I'm curious how low I need to go for further testing. Hoping I'll come up on my own. But my count is always around 3. Hoping others will chime in.

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  • Alicethecat
    Alicethecat Member Posts: 535
    edited September 2014

    Hello Robsp

    Sorry to hear you're going through this.

    The same thing happened to me. It took about 15 months after the end of chemo - and three months after Herceptin - for my blood count to come back to normal. My neutrophils went down to 0.7.

    But the good news is that they did come back. My onc wasn't worried because he said that sometimes it does take a little time for the counts to get back to normal. No mention of having a bone marrow biopsy.

    Hope all goes well for you.

    Alice


     

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  • atanea
    atanea Member Posts: 58
    edited November 2014

    Hi.

    They didn't, and that almost killed me, my wbc were a little low for almost a year, and finally crashed, they didn't want to do the bone marrow biopsy, and when finally did found I had acute leukemia. But in your case probably it's chemo late effect (I didn't had chemo at the first place so there wasn't any good explanation for low wbc), but if you have the chance, go for the bone marrow biopsy, that way you can know what's going on with your bone marrow. Believe me, it's so much better to have a false positive than a false negative. I wouldn't be here writing these words if I hadn't insisted or refused the bone marrow biopsy at the first place. It doesn't hurt that much (but it helps to take some Xanax before). I actually do one biopsy every three months now (for leukemia controls) and I'm still here. Actually, I will do my next one in the next week.

    Hope everything is well.

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  • robsp
    robsp Member Posts: 50
    edited November 2014

    Atanea - Thank you for your reply. My biopsy was made 3 weeks ago. The conclusion of aspirate reports was hyperplasia of megakaryocytes, discrete dysplasia of megakaryocytes and discrete bone marrow hypocellularity. The conclusion of other reports (Bone Marrow Biopsy,immunophenotyping and karyotype), are normal. Although my exams are not completely normal my MO said that it is not possible to diagnose some kind of myelodysplastic syndrome or other kind of bone marrow failure. The MO decided to do nothing now and just continue to measure the blood counts. My last blood count shows some improvement , my WBC is now 3.1 and neutrophil count is 1.6.

    The bone marrow exam is not very painful, my biopsy was with local anesthetic only.


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  • atanea
    atanea Member Posts: 58
    edited November 2014

    That's good news robsp, I'm happy for you :)

    Yes, I also do it with local anesthetic. I remember the first time I did it I was terrified, well it hurts, but not so much as I though, sometimes going to the dentist is more painful.

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