ALC is still going up

[Moonmyst]

Well, today I had another CBC. My ALC continues to go up consistently at each 2 week check and I will be seeing my onco at the beginning of Feb. In addition to the rising alc, test shows a few other little changes that i don't fully understand -- my MCV is now reading high (99.50) and my MCHC is low (30.81). However, rbc and hgb are both fine. If anyone has thoughts about this I would be interested. So, since I have been more tired and experiencing shortess of breath, I moved my appointment up from June to Feb just to stay on top of things (and maintain my sanity...) Should I be worried about these new numbers?

[MisfitK]

What actual ALC are you at?

What are your jumps?

Is this ALC being taken at your hemo's office, or at a regular lab?

With the shortness of breath, have you been sick lately? Have you taken a Covid test?

[lankisterguy Volunteer]

Hi Moonmyst,

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I believe that Spark_Plug ' s answer is very good. Like most of our blood results, the experienced doctors will usually look for a trend over several results in a series before digging deep into causes. So those values may or may not persist.

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You may have read that the CLL expert docs don't watch for ALC doubling rates under 30, so you may have regular checks at 3 months or less, vs. your previous 6 month pattern.

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Your fatigue and shortness of breath could be from any of numerous causes, so you may want to refer to this reply from a recent discussion: healthunlocked.com/cllsuppo...

And as I suggested in that reply: "You and your team should not assume that the CLL... is the only possible cause.

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Len

[AussieNeil Partner Administrator]

I've exceeded both your MCV (Mean Corpusclar Volume) of your red blood cells) and your MCHC (Mean Corpuscular Hemoglobin Concentration) during watch and wait, 3 years before my first treatment and I'm still here. Have your previous blood test results shown a trend towards these higher and lower than reference range results respectively? Mine did as my red blood cell production trended down due to increasing bone marrow infiltration and my red blood cells grew larger, containing more haemoglobin. Insufficient B12 and folate can cause this, but my results for these for both were fine. My MCV and MCHC after treatment are now as good as, if not better than they were when I was diagnosed, 14 years ago.

Neil

[Poodle2 in reply to AussieNeil]

I agree with Neil, my numbers and trends were not too dissimilar. My MCV was way higher, over 102, while my ALC was increasing and my Hb decreasing. My CLL consultant did not seem to be alarmed by that, she was very confident it was time to treat and that once my treatment starts, all numbers would get back into a normal range. My MCV is now normal and it happened very quickly.

[SofiaDeo]

I have had periods of abnormal RBC indices, both on treatment and off. To me, this indicates your red blood cell production is getting wonky and you probably are approaching treatment. If hemoglobin is found in your blood but not in RBC's, maybe you are having some hemolysis. Maybe you are iron deficient, or something else is allowing hemogobin to be made but it isn't getting into your RBC's properly. For whatever reason, your bone marrow isn't worked optimally, and unless you are iron deficient it probably is CLLaffecting RBC's.

The MCV, most commonly are B12/folic acid problems. Or thyroid. Or just a random fluctuation. If this is the first time this parameter has changed, it may simply be the latter. If there are also other inflammatory markers, indicating other inflammatory processes getting affected in your body,it's possible the CLL has affected your immune system to where you aren't making enough intrinsic factor to absorb the B12; this problem likely would also be solved by treating the CLL.

[TruthJunkie]

You have done what I would have done. Move your appointment up from June to Feb. If you feel that you need closer supervision of your numbers, then continue to be proactive for yourself.