Trying to figure out blood results?

[Bikram21]

Hi, I have my first appointment coming up with a specialist in Boston next week. These labs truly are a foreign language to me. I’m thinking it’s good because the lymphs went down ,but my WBC (which I couldn’t attach) went from 12.77 to 14.29. I don’t know if that’s a big deal? I do have a couple of small lymphs in the groin area and some in my armpits which I cannot feel but showed up on a breast MRI in February.I feel the anxiety building the closer I get to the appointment . This site feels like my lifeline. X

[cajunjeff]

Bikram, I am not an expert but to me it appears you are looking at labs done over a very short period of time - feb to may- with very minor fluctuations with your lymphocytes and hemoglobin. That would be an indication of stable disease. When our Cll is active we can see lymphocytes doubling in six months and rapidly falling hemoglobin. It’s hard to draw to many conclusions from lab work done over just a few months.

One odd result in your labs is apparently you were having very low hemoglobin back in 2013 that resolved in 2014. Did they ever find out what caused that? Some people with Cll will develop an immune disorder called hemolytic anemia (AIHA) that causes low hemoglobin. Your low hemoglobin appears to have occurred some number of years before your Cll diagnosis.

[Bikram21 in reply to cajunjeff]

I was in the hospital in 2013 having a hip replacement and lost a lot of blood so I’m figuring that was it.

[AussieNeil Partner Administrator]

You can reply to your post to add an image of your white cell blood counts, but with your lymphocyte going down, the WBC going down is most likely good news due to neutrophils going up. Your lymphocyte counts are low and stable.

Neil

[Bikram21 in reply to AussieNeil]

Thanks, I didn’t know how to add another photo. It looks like the WBC has gone up?

[AussieNeil Partner Administrator in reply to Bikram21]

As I suggested, it's the nice increase of 2 in your neutrophil count, which has boosted your WBC. That's why it's best to track your lymphocyte count, not your WBC.

[cajunjeff in reply to Bikram21]

Bikram, this might further explain what Neil is saying. WBC stands for white blood cells. There are five different types of white blood cells which includes lypmhocytes, neutrophils, monocytes, basophils, and eosinophils. A compete blood count (CBC) on a lab report might show both your total wbc (14.29) and the individual types that add up to that (like your lymphocytes (7.22) and your neutrophils (6.20)). 7.22 + 6.20 = 13.44. The rest of your wbc are eosinophils, monocytes and basophils which only account for a small fraction of your total wbc.

Cll is a cancer of our lymphocytes only, not the other types of white blood cells that make up our total wbc. From Feb to May your wbc went up slightly, but that was due to your neutrophils increasing which is a good thing, not to your lymphocytes which would be bad. As Neil points out, your lymphocytes (the cancerous white blood cell types) are quite stable over the last few months.

In time what happens to some of us is we see wbc numbers of 50k, 100k, 300k or more. At those levels the increase is almost entirely due to cancerous lymphocytes that our dividing at a more rapid weight. So someone with 100k wbc might have 95k of it in lymphocytes.

At a low level where you are now, its more important you look at what the lymphocytes do as opposed to your wbc. At higher numbers like 100k or 200k, you can look at lymphocytes or wbc, because at that level your wbc is made up almost entirely of excess lymphocytes anyway. If your wbc ever got to 100k, your neutrophils would be the same as they are now (6.20) or even lower while your lymphocytes would be over 90k.

I hope I have not confused you. Simply put, its only the lymphocyte type of white blood cell that is cancerous with cll. Thats why its called chronic lymphocytic leukemia. Your lymphocytes were at 7.25 in feb and 7.22 in may, so they are basically unchanged.

The normal range for lymphocytes is 1.0 to 4.8, so yours are high as one would expect with cll, but low as compared to most cll patients suggested that you might have early stage or indolent cll.

[Bikram21 in reply to cajunjeff]

Thank you! I think I’m starting to understand it a little better.

[SofiaDeo]

Seeing these results from 2013 to this year, if you have a lymphocytosis it appears mild and fairly recent. It's elevated, but fluctuating around the number 7. Good to get it checked out, but nowhere near the 50,000 count that had me in a hem-oncs office by the end of that week.

It's hay fever season in the US & elsewhere. As AussieNeil says, a number of things can cause overall WBC to fluctuate. Even your hydration pre bloodwork can make numbers pop in & out of "normal", or fluctuate. It's your Absolute Lymphocyte Count that generally prompts docs to run tests determining if you may have a problem. And is likely the reason you are being seen, since 7 is an elevation that needs followup.

Your anemia from 2013 has resolved.

It's a good sign that your Absolute Lymphocyte Count is not rising drastically. Many people here get a technical diagnosis of CLL, but their disease doesn't grow to the point of needing treatment. Their body is able to destroy most of the cancerous cells before they can overtake the non cancerous ones. They stay in a period called Watch and Wait. It's good to know if your immune system is stressed, you can avoid more stress to it, and learn to hightail it to the docs sooner rather than later if ill.

See the number for Bands? Any elevation there often indicates an infection of some sort, or your body fighting an infection off. That would cause a rise in WBC total and is normal.

Take a deep breath & don't panic. You are seeing someone to figure this out, that's the best thing to do at this time!

[Bikram21]

Thank you. I feel like I’m learning a new language!

[SofiaDeo]

Have you checked out the LLS.org and CLLsociety.org websites, as well as the Pinned Posts section here? You are indeed learning a new language, medical terminology! lololol the more you understand the basic terms, the better and more informative the doc appointments go IMO. It has been my experience that healthcare professionals give more information to people who seem knowledgable, and aren't likely to panic when we are discussing side effects, etc. I know I certainly did. Patients who can calmly say "in your experience, what is the percentage of people with that awful effect/outcome" as opposed to the patients who start crying. You don't continue to give a lot of information to the criers after an initial outburst, if for no other reason than you don't want to continue to upset them.