Questions about lab results

[Poolgirl]

Hi all,

I was diagnosed (to my surprise like all of us I am sure!) with CLL 6 years ago. Still in watch and wait and hoping that continues. I live in the US but am currently in beautiful Australia for 3 weeks. Before I left my gyno did some lab work and my lymphs absolute have doubled in 6 months. My WBC is still 25.9 but my lymphs absolute are now 21.6. Can someone please explain the significance of lymphs absolute? I forwarded my labs to my CLL doctor prior to my departure and will see him on my return. Have been having recent pins and needles in legs - is that a CLL thing?

Prior to this I may have only commented on a post or two and not asked any questions but I am so thankful for this site and all of you.

[Rohail]

Poolgirl

This is just my understanding in laymen terms. The ALC is reflective of the additional cancerous lymphocytes that your body is producing that are not helpful in fighting any infection. They are basically immature lymphocytes that are taking the space of healthy lymphocytes thus reducing the ability of your immune system to fight infection. As I understand it, numbers doubling at your levels is not as significant as numbers doubling at higher levels. I would expect that your CLL specialist will still keep you on W&W since you are not exhibiting any of the B symptoms. You can read up more on B symptoms on the cllsociety website.

[Poolgirl in reply to Rohail]

Rohail, thank you so much for your response. I do appreciate it and feel a bit relieved. Stay well

[lankisterguy Administrator Volunteer]

Hi Poolgirl,

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I agree with everything that Rohail said. Your posted values sound believable at ALC 21.6 vs WBC of 25.9 . Your doctors should continue to monitor your ALC as it slowly rises, looking for other symptoms (this past posting may help you understand what signifies the need for treatment: healthunlocked.com/cllsuppo... )

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What I would question is your results from 6 months ago, an ALC of 11 vs a WBC near 26 is weird. If you have access to a patient portal that includes your test results, please look for the graphs of past results showing your ALC & ANC (Neut#) over time since your diagnosis. The ALC should be a steady increasing trend and the ANC may bounce around but rarely reach close to 15.

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Len

[Poolgirl in reply to lankisterguy]

Thank you for your response. Most appreciated.

[MisfitK]

To add, if the ALC did double in the 6 months, at the overall level you are and no B symptoms, the doc won't care much. However, he might decide to increase the watch and wait data points by bringing you in for more appointments per year to see if that path will continue, or slow back down.

So, if you are on 6 month appointments, you may (or may not) drop to 3-4 months between appointments after this lab work, or after the next lab work in 6 months if the trend does not slow.

[Poolgirl in reply to MisfitK]

Thank you for replying. Most appreciated

[scryer99]

ALC doubling in six months may be a concern, but my understanding and experience is it generally won't be addressed immediately at your current ALC levels. There's enough noise in absolute lymphocyte data that one reading can make doubling time change quite a bit. Just looking at my data (had 20+ readings this year), readings can vary 10-20k/uL or more off trend line from test to test within a week or two.

Hence, doubling from 10 to 20 in six months won't be seen by your doctor as a big deal yet. Doubling from 60 to 120 in six months would be somewhat more concerning, but even that would not trigger treatment absent other symptoms. I was doubling every three months but that did not trigger treatment; what triggered treatment was spleen swelling and laceration plus low platelet counts, along with that ALC number.

[Poolgirl in reply to scryer99]

Thank you for your reply. Most appreciated.