blood film morphology

[Cityreach]

Hi hoping someone can help with this I was given a copy of blood film results last week which were taken whilst I was at consultation on 8th nothing was mentioned about this result on the day so hoping does not mean too much but have not seen this test done before or at least not seen results from any done prior

blood film morphology

red cell morpholgy: unremarkable

white cell morphology: unremarkable

platelet morphology:

anisocytosis,very large forms seen OA(SpR)

I have PV and normally my platlets are roughly in range with an odd blip of elevation but then return to within range

 on the 8th Aug when blood film was taken platelets were 374 then on 19th were 425 I have had big drops in the past too being 269 and 158, should I now be worrying about platlets as well as HCT,

I am justing getting nearly into range with HCT and Hb, not on meds yet just venesection and asprin

nothing was mentioned in the consultation about the morphology and those results would have been available

am I just worrying as not seen these test results before

[hunter5582]

Anisocytosis is the medical term for having red blood cells (RBCs) that are unequal in size. Normally, a person's RBCs should all be roughly the same size. Anisocytosis is usually caused by another medical condition called anemia. It may also be caused other blood diseases or by certain drugs used to treat cancer.healthline.com/health/aniso....

The thing to understand about using venesection as the treatment for PV is that it is intended to induce chronic iron deficiency to control the erythrocytosis. The iron deficiency can have its own side effects. These include reactive thrombocytosis. Some people with PV will experience thombocytosis in addition to erythrocytosis. If your platelets are borderline high or already elevated, venesections will likely push them even higher. In my case. venesections increased PLT +200K.

Depending on how high the PLT go , the elevation may not be significant. 425 would not be a concern. In my case, PLT = 900s. That was high enough to be concerned about increased risk of hemorrhage, which has been a problem in the past.

If you look at your CBC, you will likely see an elevation in RDW (red cell width distribution). Please be sure to review all of you labs with your hematologist. Your care team can do the best job explaining what it means in your case.

Meanwhile, you may find this helpful.

youtube.com/watch?v=Xj_yE1p...(Not working as expected?)

[Cityreach in reply to hunter5582]

Thanks Hunter for your wealth of knowledge on MPN's, I will take them back next time I am seeing consultant, I don't get copies from consultation appts although have not asked at these appt I always get them from the blood day clinic where they always happy to give them so miss the opportunity to talk with consultant that day about tests that day, I will review that, I am thinking about meds as have been asked to , but they were happy to wait to start until BMB and a scan are done with I am still waiting for an appt they did say early Sept so will see if not will bring up at next consultation 26th Sept, my iron level in May was 10.8 I believe that is just under starting point range being 11-29, my RBW on 19th Aug was 14.4 says range is 11-16 and is varies between 15.9 being the highest 14.4 being lowest, is there any further risks for us that blood cells are not the size they should be, sorry that may be a silly question, still trying to find my way with this

[hunter5582 in reply to Cityreach]

The question is not at all silly but does require a nuanced answer. There are a number of different reasons that the range of blood cell sizes can vary. There can be different reasons for larger RBCs. In and of itself it may be nothing to worry about but nice to have an explanation for.

Suggest you watch the video and take notes so you can be ready for the next appointment with the hematologist. It helps if you have a basic understanding of the terms used.

[Cityreach in reply to hunter5582]

Thanks Hunter I have just actually finished watching it it really does help having it explained and will go armed with questions at next appt, when all this began for me I had done a bit of research before getting referred to heamotologist and thought it was only about getting your bloods under control although I know it is important but there is so much more to learn about it and if it was not for this site it makes me wonder how we learn more about symptoms, reactions and sude effects etc I admire your knowledge and helpfulness

[hunter5582 in reply to Cityreach]

The good news is that there are more resources and plenty of time to learn what you need to know. Just take it in manageable pieces and at your own pace. It really helps to build a base of knowledge about the underling physiology, genetics, cell biology, and other aspects related to MPNs.

Here are a couple more items of interest.

MPN Molecular Biology

youtube.com/watch?v=zHwTIJb...(Not working as expected?)

Polycythemia Basic Science

youtube.com/watch?v=pWGRT17...(Not working as expected?)

[Cityreach in reply to hunter5582]

Thanks so much Hunter

[Rem31]

I think it’s possible blood films are sometimes done without us patients realising as we’re so focused on the FBC results. I now always ask the phlebotomist which tests have been requested. A blood film is done from the same FBC sample and in my case it’s occasionally requested as part of an overall check for any changes.

In the past I’ve been told blood film report ok and I only became aware of what a report can look like when, during lock down, I had regular FBCs done locally via the GP. I would then see and send results onto the clinic. On one occasion the GP took the opportunity to add in cholesterol, diabetes and umpteen other blood tests. A blood film wasn’t requested but the lab did one anyway.

I doubt my GP would have understood my blood film report and on my own I’d have been researching various terms and jumping to all kinds of out of context conclusions. So for me, as long as the haematologist is content with it then I’m happy not to go into detail over it. If they were to say something tricky is highlighted then I’d be questioning and wanting to delve into the detail.

[Cityreach in reply to Rem31]

Thanks so much good advice I do over analyse any new term I come across Thanks so much gor taking time yo reply have a good weekend