A little help with results

[Clsmith]

Back from the doctor with what I am supposing is good news. My doctor has a very thick accent and though I believe him to be very good, I sometimes have a little trouble understanding him. LOL

Platelets are now in the normal range. Were 82 now 190.

C reactive is down.

No h. Pylori.

This is what I need explained. Lymphocytes were 1.54 and are now 22.7. He says that is not important. Could someone please explain this to me.

All of this after two rounds of dexamethasone.

Thank you

[AussieNeil Partner Administrator]

Short answer is that with ITP, you are at a greater risk of complications from falling platelets than climbing lymphocytes and dexamethasone has had the desired result of boosting your platelets well into the normal range. Great News!

An increase in Absolute Lymphocyte Count in CLL (and I presume Marginal Zone Lymphoma patients) when given dexamethasone is also a well known side effect. From Chaya Venkat's CLL Updates:

updates.clltopics.org/1562-...

'There is another reason why ALC can go up suddenly. Some drugs, such as steroidal drugs (prednisone, dexamethasone etc) or immune modulating drugs such as Revlimid (lenalidomide) can cause dramatic increase in ALC. In the case of steroids it is because the drugs cause cells in the lymph nodes to get flushed out, dumped into open blood circulation. All those CLL cells hiding out in the swollen lymph nodes suddenly getting kicked out into the blood will make the ALC numbers shoot up. But this is nothing to worry about. In fact, it is one of the reasons why high dose steroids work in the case of patients with bulky lymph nodes. Once the CLL cells are out in the open blood, they are fair game and much more easily killed. This is one explanation of why combination therapies such as Rituxan + HDMP (high dose methyl prednisolone) and Campath + HDMP work well in bulky adenopathy cases. The high dose steroids do a good job of flushing out the CLL cells into the open, then the monoclonal antibody drugs (Rituxan or Campath) get a chance to kill them before they can hide again.'

The spleen can be considered a giant (albeit specialised) lymph node.

Neil

[Clsmith in reply to AussieNeil]

Great answer again. Now I understand. Thank you