Trouble with reading blood test

[Waves01]

Hi, I thought white cells went up as you progressed? I have SLL and all my nodes are getting bigger but this weeks blood test had lymphs, WCC and neuts all taking a deep dive to just now within accepted minimum range. I understand the platlets drop as well. Doesn’t one indicator for treatment include high white blood count ? LD (290) has taken a big jump just above high limit.

Confused 🤨

[Waves01]

Thank you. Makes sense

[AussieNeil Administrator]

Hi Waves,

This post includes coverage of the well respected publications on the diagnosis, management and treatment recommendations for CLL. None of them include a high white blood count as one of the indicators for starting treatment. It's the doubling time of the lymphocyte count which is monitored, particularly when the lymphocyte count exceeds 30(,000). Other blood count thresholds for starting treatment are platelets and haemoglobin falling below 100: healthunlocked.com/cllsuppo...

I can't comment on your blood count changes without your actual figures, which I appreciate you may not want to share on an unlocked post. Drops in platelets, haemoglobin and/or neutrophils are common but not inevitable; they are just reflections of what can happen with CLL/SLL, namely spleen enlargement, bone marrow infiltration and/or possibly auto-immune destruction of blood cells. Your higher LDH may reflect more active CLL/SLL, or just the result of poor blood sample taking and/or poor transport and processing. The latter can cause LDH in CLL cells to be released into blood plasma when the cell walls are ruptuted by rough handling.

Neil

[Waves01 in reply to AussieNeil]

Thanks Neil. Appreciate the answer. Was a bit confused on the WCC lowering. WCC 11.1 to 6.6 ...neuts 5.6 to 3.4....lymphs 6.1 to 2.4...platlets 200 to 171... LDH 223 to 290 all in 3 months. Thought out readers might be interested. Seem to be sliding down but still feel reasonably good 😀 Thanks again.

[AussieNeil Administrator in reply to Waves01]

With CLL, we learn that it's trends that are important. In your case with more of an SLL presentation, your lymphocyte count drop is, I would say, likely typical. I saw similar changes back when my lymphocyte counts were that low, as my CLL/SLL moved from an 'SLL' to a 'CLL' presentation about 2 years after my diagnosis. It's good news for you this time, but don't be surprised if they are higher next test. I suspect your next LDH will be lower again too. Neutrophils bounce around too, plus it's possible to temporarily boost them with strenuous exercise. They can flood out of the spleen, where some are stored, in order to fight an infection., e.g. from injuries.

Neil

[Waves01 in reply to AussieNeil]

Thanks Neil. Always helpful.

[mantana in reply to Waves01]

I had WCC drop from record high at >28 to around 9, across many months. Since then, they are slightly increasing, around 14 now.

My platelets remain low at around 100, hemoglobin is slightly dropping from blood test to blood test (at a lower norm limit now), spleen is enlarged, nodes not enlarged, LDH above 300.

So... everyone seem to have a different path in it.

[Waves01 in reply to mantana]

Thanks for your answer. Appreciate it

[lankisterguy Volunteer]

Hi Waves01,-

Your profile does not indicate your country, but some earlier postings seem to hint at Australia.

However, if you don't mind the time of day issue, you may want to join this online webinar by the CLL Society

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cllsociety.org/blood-tests-...

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Upcoming Webinar

Learning to Decode Your Blood Test Results for CLL will be held on Tuesday, June 29th at 10:00 AM PT (California) and 1:00 PM ET (New York). Do you ever look at your blood test results from the lab and feel like you are reading Latin? Or you see a result that is outside of the normal range and aren’t sure if you should be concerned? Join CLL Society and Dr. Susan Leclair for this valuable webinar. You will learn how to interpret your blood test results and gain a better understanding of why it is critical to be on top of tracking them in CLL.

Meanwhile, check out these helpful CLL Society lab test links:

• Keeping Track of Lab Results cllsociety.org/toolbox/keep...

• Normal Lab Values cllsociety.org/toolbox/norm...

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(The CLL Society really does welcome participation by CLL patients from other countries, for online events, assuming no insurance or legal restrictions are involved)

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Len

[Waves01 in reply to lankisterguy]

Thank you Len. Will do. Yes Australia

[LeoPa]

If the nodes are getting bigger and blood levels drop they likely went into the nodes?

[Waves01 in reply to LeoPa]

Thank you

[wizzard166]

Very little information to go on here, such as how long have you been on Watch and Wait. What levels did your WBC go to at what intervals over time? What was the length of time between the two readings that makes you say the WBC dropped precipitously?

WBC can go up and down in cycles; at least, that is what I've experienced. I once had my WBC go from 30000 to 45000, which is 50%, between October 2019 and December 2019. I had a good Hematologist in my local area, but decided to seek out one of the best in the Country, and had my first visit with her in Boston in February 2020. She too was concerned with the big increase in a short time, but reminded me that I mentioned having a cold I couldnt beat during a very heavy work period from October to December. She said lets check blood again in three months. In three months it was back down to 35000. This past April my six month visit in Boston showed a count of 57000, but it had been 40000 the prior December. I just had blood work again for a different reason a couple of weeks ago, and it has stayed at 57000 between this past April and now in June. So you see it can really cycle and sometimes stagnate.

Carl

[Waves01 in reply to wizzard166]

Thank you