### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Dear Dr puthillath. I will get right into my issues. I have had several years now of leukocytosis ranging from 14000-30000 I am 38 years old and have always not felt myself, I get tired easily and can catch colds easily. I had a bone marrow biopsy done several years ago but results not called or followup so I thought everything was ok.  I just recently had lower back, groin and hip pain. also intermittent left rib pain, not excrutiating but a gnawing pain. I got my past results from hospitals including biopsy results.  I would like to know if you can explain these results to me and see if it should be followed up even though they are several years later. Bone Marrow results-This is not a full report but gave some info.Cellularity5 50% estimated E:R4.1, with progressively maturing mildly dysplastic granulopoeisis and hypochromic erythropoesis. adequate megakaryocytes and mild plasmacytosis also decreased stainable iron. Blood Smear- mild anisopoikilocytosis with hypochromia and many target calls. There were rare tear drop forms.  WBC showed many hypersegmented polys which were macrocytic. There were rare myelocytes present. Platelets normal. If you can please break this down for me and let me know what it means it would be great!   Thanks, Melissa

### output:

Hi, If I were your treating Doctor for this case, I would come up with following interpretations: 1. The blood picture: mild anisopoikilocytosis with hypothermia and many target calls. There were rare tear Chat Doctor.  WBC showed many hypersegmented polys which were microcytic. There were rare relocates present. Platelets normality just indicates that there is a possibility severe Megaloblastic anemia possibly related to Vit-b12/Folic acid deficiency.2. Cellular 50% estimated M:E =4.1, with progressively maturing mildly dysplasia granulopoeisis and hypodermic erythropoietin. Adequate megakaryocytes and mild plasmacytosis also decreased stainable iron.It indicates iron deficiency also, in addition to Vit-B12/Folate deficiencies! In addition, the number of blood-producing early cells is also reduced overall and some early dysplasia/malignant cells also could be there! However, I think you should not worry too much, and you should take iron, folic acid, Vit-B12 for 4-6 weeks and get a routine blood test done! Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.