Bone Pain/Leukemia

[JoshNY]

Hello.  I am a 25 year old male with no remarkable medical history and no major family history of heart disease or cancer, although some relatives (maternal grandmother, aunt and cousin) have diabetes.

Back in May I developed a number of persistent symptoms, namely bone and joint pain, unexplained bruises, and also delayed/slow healing of some cuts.  I had blood work and everything was normal.  The symptoms persisted, however, and I was concerned I had leukemia.  I ended up seeing a hematologist and having a bone marrow biopsy and aspiration, which came back normal.

My question is this: if leukemia begins with one cell in a certain area, and then from there develops, is it not possible that the leukemia is developing from a site other than my hip bone, where my bone marrow sample was taken from?  And if that is so, then isn't possible I have leukemia, although it wasn't detected from the bone marrow workup from my hip?  For example, maybe the leukemia is developing in my sternum, and therefore no leukemia cells would be present in the hip bone.

Anyway, this may sound crazy, but I just don't understand why I continue to have pain in my bones and joints, especially since I'm so young.  The pain isn't terrible, more of an ache, and it usually only lasts a few moments.  Sometimes it will come and go throughout the day, and sometimes I may go several days with no aching at all.

Thanks.

[osteosarcomagirl]

A related discussion, Maybe Josh has rheumatoid arthritis? was started.

[Kevin Pho, MD]

I agree with the workup thus far.

Leukemia is not a localized disease, thus the marrow biopsy at the hip bone is appropriate to look for possible disease.  

If the bone pain continues, I would consider a bone scan to look for any bony lesions or masses.

A blood count, clotting time, and coagulation studies can be done to evaluate for any bleeding disorders.  

I would also consider an ANA level and rheumatoid factor to exclude rheumatologic disease.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[JoshNY]

I thought I should mention I had the bone marrow aspiration and biopsy in June.  Also, I haven't noticed many bruises lately, although it does seem like minor cuts and wounds are taking a little longer to heal than they used to.