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Just signed up. Question about "dry tap" bone marrow tests.

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Hi, I just hit my 6 month treatment mark on SpryCel and doc had me repeat the bone marrow test. 6 months ago it came up as a "dry tap", and I think he was expecting it to be not dry by now as I have responded well to the SpryCel. However, once again it came up "dry". The first time he said it was likely due to the marrow being "packed" with cml ph+ mutant cells, this time he said it could be due to "scar tissue". In any case, next he thinks he will sedate me to be able to use a larger needle to perform a more rigorous bone marrow aspiration and biopsy. This is all well and good but now I am concerned that my chances of remission are endangered. I can find very little info on that that is comphrensible, and none whatsoever that is the least bit reassuring. Does anyone know anything about bone marrow dry taps, scarring, etc.? 

I'm so tired that's about all I can write for now. I hope I made some kind of sense, Thanks, Renz

Perhaps your doctor meant fibrosis, when talking about "scar tissue". You can read a bit more about that here:

http://www.mpnresearchfoundation.org/2014-Fibrosis-focus-area-two

To test for fibrosis, if I'm not mistaken, involves a trephine along with a normal bone marrow aspitarion. This is indeed a wider needle and it takes a bit of a core bone / marrow sample so it's a bit more sore afterwards than a standard BMA. I've had this done myself, and while it's uncomfortable for a few days it's not something to be concerned about.

Fibrosis is not necessarily permanent and the bone marrow can recover following treatment but I don't think it's a quick process. Here's an interesting paper discussing 2nd generation TKIs after imatinib: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373740/

David.