In this episode of the IMF’s weekly web series, #AskDrDurie, IMF Chairman Dr. Brian Durie explains what dysplasia means when it shows up on a bone marrow report.
DR. DURIE: This week’s #AskDrDurie question is about the bone marrow report, and the patient asks, ‘What does it mean when, within the bone marrow report, the word ‘dysplasia’ is used?’
Well, dysplasia is a very important word in a bone marrow report because it usually indicates that there is some problem with the normal bone marrow cells—that there is dysplasia in the production of normal blood cells. And this means that there could be a reduced capability of the bone marrow to produce white cells, red cells, and blood platelets.
And so, if the pathologist sees that the normal bone marrow cells are looking abnormal, this is a very, very important observation. And so, if this is linked with the situation where there is anemia, where there is a low white blood cell count or a reduced platelet count, the doctor has to pay close attention to this because this could be sufficiently severe that we use a term which is called myelodysplastic syndrome- MDS- and this means that there is a significant injury to the normal bone marrow cells and reduced capability to produce normal blood cells.
In this situation, the doctor treating the myeloma has to be extremely cautious that the treatment which is used is not further damaging these normal bone marrow cells and reduce the blood counts further. And so, the selection of the treatment needs to be considered very, very closely—to have treatment which is obviously very good in eradicating the myeloma but which is not a type of treatment which will really reduce the blood count levels in a more permanent fashion.
And so, in this situation, the doctor and the patient have to discuss the meaning of the dysplasia—is it mild or is it severe, and what modifications of the treatment are necessary to have an ideal response in terms of myeloma benefit but to reduce any possible negative impact about the normal bone marrow cells.