Q: My mother is suffering from severe anaemia. The biopsy report says micromegakarocytes cluster seen. Supporting report shows raticulin stain grade 3. Doctor started the following treatment - Danogen 100 mg (1-0-1); Hosit (1-0-1); Folic acid 5 mg (1 a day). This problem started a year back. Presently we are giving blood transfusion (2 packed cells) every month to keep her haemoglobin level around 9.0. Her erythropoietin level is 1264 mu/ml. What treatment should we follow? Is there any treatment available in allopathy, homeopathy or ayurveda? She has hypertension for which she takes Amlodipine 5 mg (1 a day). She also has an orthopaedic problem, for which she underwent a neurosurgery operation in 1997. She feels giddy and has a headache along with nausea, sleepiness, weakness & nervousness. Will yoga be helpful in treating the above mentioned illness?

A:From your description it appears that your mother is suffering from myelofibrosis. Agnogenic myeloid metaplasia is a hematological disorder (one of a group of myeloproliferative disorders) characterized by anaemia, bone marrow fibrosis, extramedullary hematopoiesis (formation of blood cells in other tissues) and enlargement of liver and spleen. Most patients have anaemia and may suffer from easy fatigability, weakness, breathlessness and palpitations. The anaemia is multifactorial and is caused by ineffective erythropoiesis, erythroid hypoplasia, and hypersplenism. Enlarged spleen (splenomegaly) may lead to a feeling of early satiety and pain in the left upper abdomen. If there is a hypermetabolic state then one can suffer from weight loss, night sweats, and low-grade fever. Some patients develop bleeding due to a combination of platelet dysfunction and coagulation abnormalities. Treatment is mainly supportive and none have been shown to consistently prolong survival. Asymptomatic patients are kept under observation. Severe anaemia and thrombocytopenia require appropriate transfusion. Folic acid supplementation is often helpful but the anaemia is usually unresponsive to erythropoietin. Please consult a clinical hematologist for management as she would require cytogenetic studies and a regular follow-up. Treatment options may include use of cytoreductive therapy, radiotherapy, androgens/steroids, or even a stem cell transplant. The possibility of a myelodysplastic syndrome too needs to be excluded. We are not competent to comment on the use of alternative forms of medicine.