Anyone out there with a very high ALC and not ... - CLL Support

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Anyone out there with a very high ALC and not needing treatment.

helenolton profile image
27 Replies

I just came back from the Dr. and my ALC is 63.5 getting near treatment. Just wondering if anyone has higher numbers than this and not needing treatment.

Thanks,

Helen

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helenolton profile image
helenolton
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27 Replies
AussieNeil profile image
AussieNeilPartnerAdministrator

No, no, no, Helen! If your ALC is the only reason your doctor has given to you for nearing the need for treatment, RUN to another specialist. Read the following to understand why I say this:

The 100k myth

healthunlocked.com/cllsuppo...

How high can you go?

healthunlocked.com/cllsuppo...

When do white cell counts trigger treatment?

healthunlocked.com/cllsuppo...

Enjoy a long period of Watch and Wait; you may never need treatment!

Neil

helenolton profile image
helenolton in reply toAussieNeil

Thank you for that great information.

AAli profile image
AAli

Hi Helen,

My AlC touched 228 and now is 184 but my doctor not advised any treatment. As Neil said ALC alone could not be a justification to start treatment.

Best wishes and stay blessed

helenolton profile image
helenolton in reply toAAli

Thank you.... I feel so much better seeing people with high ALC and not needing treatment.

Graham2222 profile image
Graham2222

I started treatment at 252. The trigger was a very rapid rate of increase over a short period - quadrupling in 3 months - and some other B symptoms.

helenolton profile image
helenolton in reply toGraham2222

Wow .... It is really great to get this information.

bkoffman profile image
bkoffmanCLL CURE Hero

Helen,

Every good doctor should know that you treat the patient, not the lab test. Unlike CML, counts can climb to very high levels in CLL without any increased risk of stroke or clots.

I have known folks with counts over 700,000 who did not need therapy.

Stay strong.

We are all in this together

Brian Koffman

Volunteer Medical Director

cllsociety.org

helenolton profile image
helenolton in reply tobkoffman

Thank you,

Bubnojay profile image
Bubnojay

Hi Helen

It occurs to me to ask, how are you feeling? If you are feeling ok except for some tiredness and maybe a broken thermostat then I would not put myself through treatment yet.

At least not before seeking a second opinion.

Good luck

Bubnjay1

helenolton profile image
helenolton

Thank you ....I will get a second opinion.

joed1rt profile image
joed1rt

My ALC was around 55 on my last appointment and treatment is not even being considered. Still on 6 month checkups. Doc said they don't see me needing treatment anytime soon. Get a second opinion for sure.

PaulaS profile image
PaulaSVolunteer

My ALC was approaching 300 when I started treatment. And it was my large spleen that meant treatment was necessary, rather than the blood counts. (Spleen was pressing on the stomach, stopping me eating properly).

Everyone's different though. Sometimes people get very enlarged lymph nodes that press on various other organs in the body, which can cause problems and necessitate starting treatment, regardless of their ALC.

Best wishes,

Paula

Cllcanada profile image
CllcanadaTop Poster CURE Hero

There is a case to be made where counts apply...in pretreatment...

Absolute lymphocyte count (ALC) is considered in pretreatment assessment... if your lymphocytre count is well over 30K and it doubles in a period of 6 months, then a treatment assessment may be done, looking primarily at B symptoms, your physical vigor, and perhaps a prudent CTscan would be ordered to see internal node involvement...

But on their own counts should not be the sole reason for treatment...

~chris

helenolton profile image
helenolton

My platletes are 119 were 89 and RBC 3.6 and my spleen is mildly enlarged. Is Dr Byrd the best CLL dr. for a second opinion. Thanks everyone for all your valuable information.

Helen

AussieNeil profile image
AussieNeilPartnerAdministrator in reply tohelenolton

If you can see Dr Byrd, look no further. Platelets consistently under 100 and dropping or Haemoglobin under 10 (more accurate than a RBC) are reasons for starting treatment.

Neil

helenolton profile image
helenolton in reply toAussieNeil

Thanks Neil

ThreeWs profile image
ThreeWs in reply tohelenolton

You could not do better than Dr. John Byrd even though there are other highly competent CLL specialists. The James Cancer Hospital is now the third largest cancer hospital in the US having just opened in Jan. 2015. Byrd and colleagues work with the most advanced CLL drugs. John's knowledge of drugs and CLL biology saved me from a potentially deadly therapy recommendation of a heme/onc and bone marrow transplant specialist in NY.

WWW

alexmcg48 profile image
alexmcg48

I was told at the outset my count could go up to 150 or so & I still might not need treatment. Treatment depended on how I was in general & whether I was getting or showing any associated symptoms.

ThreeWs profile image
ThreeWs

Hi Helen,

ALC (Absolute Lymphocyte Count) at 63.5 k is not actually very high. Remember that CLL cancer cells in the peripheral blood as measured by ALC are largely cells that are worn out from reproduction signaling activities while they were in the germinating centers of the lymphnodes and bone marrow. They migrate out into the blood for a vacation and to reinvigorate before returning to the lymph node tissue breeding compartments. These peripheral blood ALC cells are not where the action is and is why some patients have been able to remain treatment free with counts over one million.

I had an ALC count of >300k but it was the massive nodes impeding breathing and the anemia from the 91% bone marrow infiltration that drove me into treatment, not the ALC count.

WWW

helenolton profile image
helenolton in reply toThreeWs

Thank you,

Ezjacobs profile image
Ezjacobs

Helen,

My WBC count last week was around 75K and I am still watching and waiting. So far I feel good. I may need treatment with a steroid and Rituxin because of my Auto Immune Hemolytic anemia (CLL related) which has been keeping my red blood cell count in the 10.5 range. If it goes below 10 I will need treatment for it. I think they base need for treatment for the CLL on the rapidity of the doubling of the numbers and symptomatology. I have heard of people with a lot higher numbers than mine still in W and W. We shall see. Elaine

helenolton profile image
helenolton in reply toEzjacobs

Elaine,

I asked the Dr. what drugs I would be taking and they were Rituxin, Bendamshine Phoshate and Decednor. I may misspelled the names of the drugs because I cannot read my Dr. writing. Sounds like we might be taking the same treatment in the future.

Thanks,

helenolton profile image
helenolton

Thank you Elaine

Ezjacobs profile image
Ezjacobs

Helen,

Bendamustine is a chemotherapy. I am not familiar with Decednor. I would be treated only for my anemia at this point and not for my CLL. I suggest that before your go on you get a 2nd opinion from a CLL specialist! The treatment your doctor is proposing is serious business.

helenolton profile image
helenolton in reply toEzjacobs

Thank you so much for that information. I keep telling the Dr. I cannot take any medicines. Every drug I have taken in my life I have been admitted to the hospital except for Antibiotics. He makes it soud like these drugs will be no problem for me that scares me ,becaus after reading all these posts there are so many side effects.

emmiekay profile image
emmiekay

I can't tell from my lab results which is my ALC. It says Lymphs-96.1 and Lymph#-136.58. Not sure what the difference is in these two.

AussieNeil profile image
AussieNeilPartnerAdministrator in reply toemmiekay

Lymph# is your ALC. Ignore the 96.1 result as that would be the percentage of white blood cells which are lymphocytes - a useless figure if you have leukaemia.

Neil

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