I found CLL club is very helpful and people are very cooperative so I decided to put my query today.
This is one of the blood tests of my wife in November 2020 and I am presenting since I took the help of google but I am still unclear:
#Partially CD5+ monoclonal B-cell population detected.
#Blood shows 94 % viability
# Lymphocytes are 69 % of total cells
# CD19+/CD20+B-cells are 56 % of total cells (absolute 12.3x10 CD
#CD 3+T-cells are 11 % of total cells and show normal CD4/CD8 ratio and expression of CD5. No increase of CD56+NK cells or T cells with large granular lymphocyte (LGL) -related CD57+ phenotype is noted.
B-cell (CD 19+)56 % of total
Kappa+99% of CD19+
Lamda+1% of CD 19+
K/L99.00
Based on this parameter how severe is the case that I wanted to know.
I will ask more later.
Thank you in advance!
Sagar
Written by
Sagarcanada
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Sagar, if you look below your post at "more v", click on it for drop down menu, you will see "edit". Click on "edit" and you can go to the 2002 and change it to 2020--- then back to bottom of the post and click on the blue box with "edit" in it, to close your corrected post.
This is the immunophenotype flow cytometry test results that just confirms that your wife has CLL, not some other blood cancer. You've separately asked about tests that will provide you with prognostic information - and discovered that they are difficult to obtain in Canada.
So the best that you can do in these circumstances, is to just keep a copy of your wife's blood test results and look for trends in the lymphocyte count, platelets and haemoglobin and note whether physical symptoms begin to appear. You can also get some idea from how often your wife's specialist arranges blood tests and appointments. It's normal to follow new patients fairly closely initially, then spread out the frequency of these as a patient's CLL tempo becomes established. I initially saw my specialist monthly, then three monthly and finally twice a year until my time to first treatment approached, when again the time between appointments and blood tests reduced. At times, I had more frequent blood tests/appointments when my CLL compromised immunity resulted in hospital infections, but unusually, CLL/SLL severely compromised my immune system. Despite being diagnosed at stage 4, I remained in watch and wait for 11 years. CLL is a marathon, not a sprint.
Have you read out Pinned Posts section? healthunlocked.com/cllsuppo... You might find some posts there that you and your wife will find helpful.
Sagarcanada, the short answer to your question about the severity of your wife's diagnosis based on these flow cytometry results, is that your wife's CLl has been diagnosed at quite an early stage, and there appear to be no confounding factors. The absolute lymphocyte count, as recommended by @AussieNeil, will be the most important number to track, not the percentages.
In case you are interested in learning more about what the cytometry determined, I've copied your wife's report and written a short explanation about each item. The various CDs (Cluster of Differentiations) refer to proteins expressed on the surface of the different types of blood cells.
#Partially CD5+ monoclonal B-cell population detected. These are the CLL cells.
B-cells which typically express CD19 and CD20, normally don’t express CD5. When they do, CLL is usually the diagnosis.
#Blood shows 94 % viabilityThis is a perfectly normal result.
Blood cells are fragile and can be damaged by mechanical stress during handling. In Flow Cytometry it is important to get rid of dead cells because they can cause artifacts interfering with the correct interpretation of results. Frequently a viability dye is used to mark the living cells, and sort them away from any dead cells in the population.
# Lymphocytes are 69 % of total cellsThat’s outside the normal range of 20-40%.
This fraction contains T-cells, B-cells & NK cells. The next results distinguish between B-cells & T-cell counts.
# CD19+/CD20+B-cells are 56 % of total cells (absolute 12.3x10 10*9/L)
The B-cells are identified by the presence of CD19/CD20 (CD19+/CD20+) and they comprise 56% of the total cell population.
#CD 3+T-cells are 11 % of total cells and show normal CD4/CD8 ratio and expression of CD5.This is all good.
CD3 and CD5 are pan-T-cell markers. The two types of T-cells are CD4 cells and CD8 cells. Normally the ratio of T-cells to B-cells is between 4:1 and 5:1. In your wife’s case the B-cells far outnumber the T-cells. This is typical for CLL.
#No increase of CD56+NK cells or T cells with large granular lymphocyte (LGL) -related CD57+ phenotype is noted.This is a good sign.
CD56 is a marker for NK (natural killer) cells, and the normal number were found.
Large granular lymphocyte leukemia (LGL) is a clonal lymphoproliferative disease of CD8+ T cells expressing the CD57 activation marker. This was not detected.
#Kappa 99% of CD19+ #Lamda 1% of CD 19+ #K/L 99
Typical for CLL
This is evidence that the CD19+/CD5+ B-cells are monoclonal.
The CD5+ B-cells are shown to be monoclonal (derived from a single cell) by an abnormal Kappa/Lambda ratio. In this case K/L = 99
The B-cell Receptor (BCR) on the surface of B-cells is an immunoglobulin made up of heavy and light protein chains. In any given cell the light chains are either kappa or lambda proteins. The usual K/L ratio among BCRs in a nonclonal population is between 0.7 and 5.5. Clearly a K/L ratio of 99 indicates a monoclonal population! Again, that’s typical of CLL.
These are the absolute cell counts based on the data presented.
21.9 x 10*9/L total cells counted
15.1 x 10*9/L lymphocytes*** = B-cells & T-cells (normal range = 0.90-2.90 x 10*9/L)
12.3 x 10*9/L B-cells (0.8 x 10*9/L is about the upper limit of the normal range)
2.4 x x 10*9/L T-cells (right in the middle of the normal range)
***The absolute lymphocyte count rather than % lymphocytes will be the important number to track.
Please don't hesitate to ask for further clarification, and please let me know if you detect a problem with something that I have written. It's late here in Tennessee, well past my bedtime. 😌
Thank you so much Gardening-girl! great illustration and interpretation of the blood result. You made me all clear now. I am very much grateful to you. I look forward to getting such kind cooperation in the future.
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