Bone Marrow Biopsy #2 — 2025-11-28

Procedure Details

• Date: 2025-11-28
• Performed by: Bijay Prabhakaran Nair
• Facility: KIMS Health, Trivandrum

Clinical Context

Second bone marrow biopsy, performed by Dr. Bijay after the initial diagnostic biopsy (Bone Marrow Biopsy 2025 11 20) showed atypical mononuclear infiltrate with crushing artifact. This biopsy aimed to better characterize the disease and estimate blast percentage.

Specimen Quality

• Cores: 2 good cores obtained
• Aspirate: Hemodilute (again — similar to prior biopsy)
• Dr. Bijay's note: "But we should be able to get a good estimate of the blasts"

Post-Procedure

• Patient tolerated the procedure well
• Advised to take paracetamol for pain
• Warned to "expect it to be a bit more sore than last one when lidocaine effect wears off"

Results

Results became available by 2025-12-04. Discussed via 22-minute voice call between Dr. Bijay and Sameer. Report shared: "ISHAMMA T M (MR000384802).pdf" (7 pages).

The aspirate from this biopsy was also used for:
- Flow Cytometry 2025 11 28 — ~5% blasts (dilute sample)
- Karyotype 2025 11 29 — 46,XX[10], normal female karyotype. Results confirmed Dec 8: "Normal karyotype"

Associated Lab Findings

Hemoglobin had dropped since prior labs. Dr. Bijay noted: "Usually we transfuse for less than 7, but since she is not very symptomatic. Can repeat CBC on Monday and if still low then arrange transfusion." Plan was to repeat CBC the following Monday (~2025-12-01) and transfuse if Hb remained low.

Created during ingest of WhatsApp conversation (Nov–Dec 2025).