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Q. What is RAEB? What can it lead to?

Answered by
Dr. Muhammad Majid Hanif
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Dec 10, 2015 and last reviewed on: Feb 28, 2019

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 rated to be very well with no diabetes or any other medical issues. But from last year she shows a myelodysplastic syndrome. A bone marrow biopsy was attempted a couple of weeks ago. Unfortunately, the material made available to the laboratory was of not adequate in quality and no result could be given. However, I read in the report that the material was of fibrino-leukocytic consistency and assuming that there is refractory anemia with excess blasts. Is the material of fibrino leucocytic nature possibly proving the suspected condition?

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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.

Actually, when there is a hematology report which questions the quality of the biopsy specimen, we cannot just comment on the outcome of the test or to what should have had been there it was 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 preferably 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 needed.

Hi doctor,

My doubts are, is the use of the term material was of fibrino-leukocytic consistency in the report not necessarily hinting at the stage of a possible refractory anemia with excessive blasts? If the test had been done on a known healthy patient, is the same consistency of the material identified as well?

#

Hi,

Welcome back to icliniq.com.

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


The Probable causes:

1. No, a known healthy individual will not have this kind of biopsy report.
2. Now as you have uploaded the laboratory report (attachment removed to protect patient identity); the picture is a bit clear.
3. Refractory anemia with excess blasts that is RAEB possibility is high in this case. It may be RAEB-1.
4. Your patient has blood clots and fibrin in 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 counts. So, MDS clearly taking whole scenario into consideration.
5. We have to keep an eye on blast cell count. She has low counts right now, but if it increases, it may get into acute myeloid leukemia (AML), a blood cancer. The prognosis gets poorer then.


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