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LADoc00

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Okay crap, what are people using nowadays to separate the mad usage of CSF drugs like Neupogen from Chronic myeloproliferative disorders on bone marrow exams..

RyMQ Im sure Kjeldsberg told you his secrets at Utah, now tell me.

PS-Im sending a case FedEX to Appleman at Mich, Barrett's rule out low grade dyplasia (B.S. consult I know but I have to). Is he on service? Yaah, you happen to you??
 

yaah

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Whenever a Barrett's case is sent all three of them look at it - whoever writes the actual consult letter depends on who is on service this week.

In regards to your neupogen question, here it seems like they go by clinical history as we have good communication with the clinical staff. Not sure what I would do (or they would do, more specifically) if we didn't have this info.
 

LADoc00

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Whenever a Barrett's case is sent all three of them look at it - whoever writes the actual consult letter depends on who is on service this week.

3 of who? Who is them? I really dont give a rat's ass if your fellows look at it. I need elite turnaround time.
 

yaah

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Appelman, McKenna, and Greenson are the 3 GI path people here. There is a fellow too but that is beside the point. I mean, they generally show all Barrett's dysplasia and UC related dysplasia cases (They actually have a tally sheet that goes along with the case and they all check the box they think). They started doing this as a means to prove that dysplasia is not reliably diagnosed and the main criteria is "that's what it looks like." I think they agree the majority of the time or if not, 1/3 is one grade higher or lower. I think they published the results awhile back.
 

RyMcQ

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RyMQ Im sure Kjeldsberg told you his secrets at Utah, now tell me.

ARUP swore me to secrecy on this.

Honestly, I don't know how to definitively tell the difference. If I see crazy toxic granulation and lots of granulocytic precurosors, I usually call the clinician and ask if the patient is on Neupogen. Or ideally, the clinician checks the Neupogen box on the bone marrow req.
 

Patholog

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Okay crap, what are people using nowadays to separate the mad usage of CSF drugs like Neupogen from Chronic myeloproliferative disorders on bone marrow exams..

RyMQ Im sure Kjeldsberg told you his secrets at Utah, now tell me.

PS-Im sending a case FedEX to Appleman at Mich, Barrett's rule out low grade dyplasia (B.S. consult I know but I have to). Is he on service? Yaah, you happen to you??

We've been using Jak2 testing in some cases. It has some clinical utility, but it is not foolproof. It is a PCR test and has been useful in separating secondary polycythemia from PCV. Needless to say, I am not fully versed on the topic, but there you go...
 
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