What is RAEB? What can it lead to?

Question

Hi doctor,

I am writing to you regarding the health status of an elderly person. She is 85 years old and still in pretty good condition. Her current cardiological status is rated to be very good with no diabetes or any other medical issues. But since last year, she has had myelodysplastic syndrome.

A bone marrow biopsy was attempted a couple of weeks ago. Unfortunately, the material made available to the laboratory was of poor quality, and no results could be provided.

However, I read in the report that the material was of fibrino-leukocytic consistency and assumed that there was refractory anemia with excess blasts.

Is the material of fibrino-leukocytic nature possibly proving the suspected condition?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have carefully worked through your case and want to assure you that proper care and expert opinion will be extended.

When there is a hematology report that questions the quality of the biopsy specimen, we cannot just comment on the outcome of the test or what should have been there if it were like that or the other way.

The fibrino-leukocytic consistency just means that there were just a few leukocyte cells in the background matrix of fibers.

I prefer to suggest that this is a mistake in taking the proper specimen, or if the technique was fine, then due to the replacement of the bone marrow with fibrous tissue to some extent, causing anemia. My final suggestion is to repeat the diagnostic test and expert hands as needed.

I hope this helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

No, a known healthy individual will not have this kind of biopsy report.
Now, as you have uploaded the laboratory report (attachment removed to protect patient identity), the picture is a bit clearer.
Refractory anemia with excess blasts, that is, RAEB, is high in this case. It may be RAEB-1.
Your patient has blood clots and fibrin in the biopsy report. She has MDS (myelodysplastic syndrome), and multi-lineage cell lines are decreased; that is, many cell lines, RBCs (red blood cells), WBCs (white blood cells), and platelets are low in count. So, MDS is clearly taking the whole scenario into consideration.
We have to keep an eye on blast cell count. She has low counts right now, but if they increase, it may get into acute myeloid leukemia (AML), a blood cancer. The prognosis gets poorer then.

I want to assure you that you do not need to worry, as everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns.

I hope it helps.

Thank you.