Possible MBL?

[naa81]

Hi

I went for a bone marrow biopsy in September 2019 as I have been mildly neutropenic for a number of years. Results couldn’t point to a particular cause of this so hematologist wasn’t concerned. He did call me back in a few days later though as he then discovered from the flow Cytometry that there was a presence of a B lymphoid clone with a CLL / SLL phenotype (5/5) They represented 2% of nucleated cells.

I think he was surprised to have discovered this result so as a precaution he sent me for a CT scan which thankfully came back clear. He didn’t seem overly concerned and briefly mentioned a possible MBL that may never come to anything but suggested repeating bloods every 6 months for now and then repeating my BM biopsy in 12 months. My lymphocytes are well within the normal range.

Basically this all came as a bit of a shock as I didn’t expect to be called back about this! I’m 38 years old and have two young children. I was just wondering if anyone is able to give any advice on whether they think there is anything in particular I need to keep an eye out for with my test results / discuss with my consultant? He didn’t seem particularly concerned and suggested it could just be an incidental finding but of course sometimes ignorance is bliss and I would have rather not known anything!

Thanks in advance for any feedback, much appreciated x

[Jm954 Administrator]

Hi there, there are probably a significant number of people walking around blissfully ignorant of having mbl, especially older people. If your lymphs are in the normal range and the mbl cells are only 2% of those then you will have a very low level indeed.

MBL consist of two groups: low-count MBL which has blood B-cell counts less than 0.5x9 cells/liter (i.e. 0.5x9/L), and this sounds like you, whereas high-count MBL has blood B-cell counts greater than 0.5x9/L but <5x109/L. While low-count MBL generally does not progress to a malignant disease but high-count MBL does so at a rate of 1-2% of patients per year.

The wikipedia is quite helpful en.wikipedia.org/wiki/Monoc...

I don't think you have anything to worry about but I do think it's worth getting screened for Hep B & C as that is more common in patients with MBL and it would be important to know if you were positive so that you can have treatment for the hepatitis.

WIshing you all the best

Jackie

[naa81 in reply to Jm954]

Thank you. You’re certainly right, there’s probably quite a few people walking around unaware of what is going on inside them! I know my levels are very low which is good so hopefully it’s an incidental finding and one which will hopefully not need any treatment in the future. I had another BM biopsy a few years ago and had no trace of the global cells then but then I guess a lot can change in a few years.

Thanks again