Q: My 77 years old mother experienced a sudden decrease of her haemoglobin level to 5 g/dl six months back. Earlier it was 10 g/dl. After that she also gets fever and is unable to eat properly. We have carried out all the tests including bone marrow biopsy. The impression of bone marrow biopsy - cellular marrow shows a mononuclear cell infiltrate with increased fibrosis. What does it indicate? Is my mother alright?

A:With six months history of anemia (i.e. low Haemoglobin) and the bone marrow biopsy showing fibrosis with a mononuclear cell infiltrate, I am afraid we are looking at a sinister problem. One would need to look at those mononuclear cells and delineate their nature further either by doing immunohistochemistry or by doing flowcytometry. Also, a review of the bone marrow by an experienced hematologist would be of help. Once the diagnosis is established, the treatment can follow.