Lymphocytes are at 26%

[Pinhead1]

What does it mean if the Lymphocytes are at 26%? I'm on Ibrutinib and Venetoclax.

[AussieNeil Partner Administrator]

Ignore all mention of percentages in your blood test reports. It's the absolute numbers and their trends that matter.

You have five different major types of white blood cells. An absolute count change in any of them changes the percentages of them all! It may be that Ibrutinib and Venetoclax have lowered your absolute lymphocyte count into the normal range, but without knowing the actual counts, it's impossible to say.

If your blood test report only lists percentages, you just multiple the percentage by the total white blood cell count to get the relevant absolute count. Your absolute neutrophil and lymphocyte counts are the most important. Neutrophil counts are commonly lowered by all CLL treatments, with venetoclax a having a particularly notable effect. Neutropenia (a low neutrophil count) puts you at increased risk of infection.

Neil

[Pinhead1 in reply to AussieNeil]

Thank you AussieNeil. He finishes the clinical trial in August and I read somewhere on one of these posts that the goal is to be at 2,900 for Lymphocytes.

[MsLockYourPosts Passed Volunteer in reply to Pinhead1]

There is no one number that is a set goal. If you look at his lab report it will give the absolute lymphocyte count, the "in range" numbers, and will usually indicate, somehow, if each count is high or low. Ideally treatment will help him to get his counts "in range". After my last treatment (Gazyva) it took my hemoglobin a little time to recover and my ALC sat low for a couple of years. My doctor wasn't concerned, so I tried not to be. She understood the process a lot better than I ever will.

[wizzard166]

Aussie Neil is correct in that the percentages are not important, but the Absolute Number is. I too was confused, and thought that the fact percentages are reported has to mean they were important. I researched this and found out that before automated machine CBC, they used a blood smear on a slide. When using a blood smear they can only do percentages. When the newer automated CBC was developed, the ability to report Absolute numbers took over in priority.

I did however find a very detailed medical analysis of the question of whether or not percentages of lymphocytes are important in treatment, and found a respected medical study that indicated they do.

In fact this study concluded that percent of lymphocytes was more important than absolute count for patients who were already undergoing chemotherapy. It is extremely difficult to read because of all the professional medical jargon, but if I understood it enough the reason has to do with treatment lowering the immune system and making it more difficult to thus fight infections. The higher the perentage then showed more accurate determination of progress in getting the lymphocyte count where it needs to be. At least my limited knowledge base while reading this study got that from it. It actually stated that LWR was more accurate and important in this instance than WC (Lymphocyte to White Ratio versus White Count). I'm not a doctor, so you can't take my analysis too seriously, but I know I read that one sentance. Here is the link ncbi.nlm.nih.gov/pmc/articl...

[wizzard166 in reply to wizzard166]

The sentence that stated Lymphocyte Percentage was more accurate than Absolute Lymphocyte Count referred to LC and LWR. These are Lymphocyte Count and Lymphocyte to White Cell Ratio.

The one situation where Lymphocyte Percent (or ratio as they call it) is in Patients who have already had Treatment. They were trying to determine Survival Rate prediction in those patients. For some reason they found that the Lymphocyte Ratio was more predictive of Survival Rate than was the Absolute Count. They stated that the higher the Lymphocyte Percentage was an indicator for greater survival rate. I don't pretend to have a clue why this is true; although, I think they are saying that the higher the percentage was an indicator that the good White Cells were coming back into ability to fight infections. Why the percentage was proven to be a better indicator in this specific life situation for already treated patients is still beyond my grasp. I'm sure someone with true medical knowledge who reads the article could probably tell us. ncbi.nlm.nih.gov/pmc/articl...