Very worried by latest blood test results

[Nanapapa6]

I have CLL and on watch and wait, however WBC has shot up to 49, smudge cells 22 and lymphocytes 26, is it time for treatment?

[AussieNeil Partner Administrator]

Smudge cells are just CLL cells. They are more vulnerable to mechanical damage during blood testing and the fragile cell walls break, giving that typical smeared appearance under the microscope. I've not seen them separately counted on a blood test result, so presume you had a manual count rather than the usual automated count.

As to whether it is time for treatment, the lymphocyte doubling time criterion for starting treatment is only assessed once the lymphocyte count exceeds 30. But even if your lymphocytes and smudged cells together are doubling in under 6 months, a CLL specialist would not start you on treatment in the absence of other treatment triggering factors. Your lymphocyte count could well stabilise at several hundred and you would not need treatment.

When do white count numbers trigger treatment?

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When to Treat

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How high can you go and what does it matter?

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Neil

[bkoffman CLL CURE Hero]

Treatment should not be based on a particular count of CLL cells and never on one lab test. Follow the trend. Even then, it is usual symptoms that drive the need to start therapy. Smudge cells are of no concern and may actually be a positive marker. Neil has given you excellent advice. Stay strong, Brian CLLSociety.org