Tear Drop Shaped Red Cells: Anyone else have tear... - MPN Voice

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Tear Drop Shaped Red Cells

George1976 profile image
20 Replies

Anyone else have tear drop shaped red cells?

Went to a new MPN specialist last week. She did a blood smear which I hadn’t had in years. Apparently I have a small number of tear drop shaped red cells. This can be related to MF but after 2 BMBs in the past 2 years my diagnosis is still ET. Last BMB scored a 1 on the O-4 scale for fibrosis. I was wondering if this is also causing me to feel so incredibly tired where I need a nap pretty much everyday and have a sick headache also everyday. She didn’t think so. They checked my iron levels and they are on the low end of normal. I was told to increase my aspirin from 160 per day to either 240 or a full 320mg.

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George1976
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20 Replies
DarcyShepp profile image
DarcyShepp

Hi George, I hope you find an answer re your tear drop shaped cells.

I don’t have tear dropped shaped cells but my BMB showed that I have stage 1 with a bit of stage 2 MF.

So they diagnosed me with early MF.

There seem to be so many variations, it’s hard to understand it all.

I’d ask for clarification from your specialist if you can.

hunter5582 profile image
hunter5582

Suggest that you ask for clarification as teardrop shaped RBCs (dacryocytes) can be associated with a number of conditions, including fibrosis in the bone marrow, VIt B deficiency, and more.

Headaches and fatigue are known MPN symptoms that can occur regardless of platelet levels. Fatigue can be related to the overproduction of inflammatory cytokines. Headaches are a likely microvascular issue. It sounds like you have already increased you aspirin from the common 81mg qd to taking 2/day. You did not state whether you were taking the aspirin once or twice per day. Some find it more effective to take the aspirin bid since the half-life of aspirin is so short. Increasing the aspirin dose might help with the microvascular aspect of the headaches if that is the issue.

Suggest you also seek clarification of strategies to deal with the fatigue. Some find the cytoreductive medication help with fatigue, but not all do. Here is a bit of information of dealing with fatigue just in case you have not seen it.

mpnvoice.org.uk/living-with...

mympnteam.com/resources/man...

youtube.com/watch?v=lGVvbTc...

George1976 profile image
George1976 in reply to hunter5582

Thanks Hunter for the link and video. I just started taking the aspirin twice a day, 81 in the morning and now another 160 before dinner. Hopefully it will begin to make a difference.

Mu55 profile image
Mu55

hi my Haematolygist at the Christies hospital tells me it’s nothing to worry about it’s the hydroxycarbamide that does that it’s so they can tell your taking it my GP rang after a blood test at the surgery I contacted my Haematolygist he explained that to me

jointpain profile image
jointpain in reply to Mu55

As Mu55 said they are on aspirin not Hydroxycarbamide, so not really relevant to them.

Phil1955 profile image
Phil1955 in reply to jointpain

sorry thought they was on hydroxycarbamide

jointpain profile image
jointpain in reply to Phil1955

But still interesting, my wife has MF and is on hydroxycarbamide and also Jakafi with the hope of removing hydroxycarbamide altogether. She has some teardrop RBCs and it will be interesting to see if they disappear in the next few months. As she is overseen by Christie's, we will ask them to check!

Phil1955 profile image
Phil1955 in reply to jointpain

I’m under Professor Sommervaille there just ask next time your in clinic

Tipsy2023 profile image
Tipsy2023

Morning George my red cell reports just said misshapen no specific shape and haematologist said not in high enough numbers for her to be interested.

But I started taking vitamin B12 which was on low end of normal and also didn’t interest my haematologist but from my point of view I have not felt so lethargic and also the constant hangover feeling headache is not there only occasionally when I feel very tired . My recent B12 result is midline in the normal range so I am responding to taking it orally. So maybe worth looking at . Feeling constantly so tired made many of the things I enjoy impossible so anything that helps is worth a try . L

George1976 profile image
George1976 in reply to Tipsy2023

Morning to you Tipsy. That’s what I was told, not enough of these cells to matter. My B12 has been pretty close to right in the middle and when I take more it makes my sick headaches worse. The headaches don’t actually hurt a lot, it’s more of a slightly dizzy very dull pain that includes a bit of nausea.

MCW22 profile image
MCW22

I have often seen tear drop cells on my blood reports over the last few years. Last December a bone marrow biopsy confirmed what I had suspected for some time, my PV had progressed to MF.

Carol

George1976 profile image
George1976 in reply to MCW22

Sorry to hear that Carol. Are you JAK positive? And have you considered Rux?

MCW22 profile image
MCW22 in reply to George1976

Yes I am Jak2 positive and I have been on rux since 2 years after my diagnosis. It was increased after the confirmation that I had progressed from PV to MF. I now take 15mg twice a day

Carol

ainslie profile image
ainslie

I doubt fibrosis 1 is the cause of your fatigue, they have recently learned that fibrosis is not as important as they used to think it was.

Not that this helps much but 92% of us with MPN have fatigue, of course if that fatigue has recently changed it needs investigation.

George1976 profile image
George1976 in reply to ainslie

Thanks Ainslie. I think you’re right. I coming around to realization that my sick feeling is probably just my blood condition getting a bit worse now that I’m 10 years into it. The 3 BMB reports over time make reference to me having signs of Primary MF but then they say if it was I would have more obvious signs of it now, 10 years later. I also need to get out and move around more and thankfully my ability to walk has at least for now improved a bit. So if I’m lucky a bit more aspirin and more exercise will help me feel better. And I did get a round of IVIG a few months ago so maybe that’s playing a role in here too with some improvement in my legs.

Cja1956 profile image
Cja1956

I have post ETMF. I have had teardrop cells for many years, but I’m wondering if you have pre-fibrotic MF since you said you’re already at fibrosis level one. I would even go for another opinion and take your results with you.

George1976 profile image
George1976 in reply to Cja1956

I’ve seen probably 7 MPN specialists in the past 4 years since I’ve developed some weird symptoms. Like Ainslie said, MPNs can give you headaches and make you tired. Plus I’m not getting any younger.

Jamesxyz profile image
Jamesxyz

Interesting.

Is blood smear part of normal labs?

Thanks

George1976 profile image
George1976 in reply to Jamesxyz

I dont think it is usually. I had a specialist years back that always did one. Seems to me the more way to get tested the better especially when you’ve already had the blood drawn.

Jamesxyz profile image
Jamesxyz in reply to George1976

I had a regular haemo that used to put it under the microscope.

But now r=that I see an MPN specialist they don't look at the blood.

They jsut get numbers from the lab.

Anyone else care to chime in.

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