I've just had a look at my latest complete blood examination, before a scheduled visit to the haemo on Wednesday. Now, I'm beyond worrying about stats. I'm in a good headspace while I watch and wait, but I just want to know what kind of questions I might need to ask him. You see, the report is significantly different from the last one, at the end of December. The white cell count doubled, from 20.83 to 41.56. The lymphocytes rose from 16.43 to 32. 42; Monocytes from .44 to .83, Neutrophils from 3.77 to 8.31, and Eosinophils have waved goodbye entirely. No red cell abnormality. I don't have an infection. So far my stats have been stable. As I say, not worried. Would just like to be armed with the right questions. I would be grateful for advice. Peace and health to all!
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Guffy
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Hello Guffy, according to the published guidelines used to determine when to treat aCll patient that many cll doctors use to determine if it is time to treat, lymphocyte doubling within six months is one of the treatment triggers. Yours have apparently doubled from 16 to 32.
Two other independent treatment triggers are low hemoglobin, less than ten, and low platelets, less than 100.
These treatment triggers often run in tandem, that is, as our lymphocytes rise, our hemoglobin and platelets fall.
They are “guidelines” and not hard and fast rules, so your doctor will likely be looking at your entire picture before rushing to treatment. If all your other labs are fine, and your hemoglobin and platelets in a safe range and not falling rapidly, he might well want you to watch and wait a bit longer and see how your lymphocytes do. His decision on when to treat might also be informed by the genetic type of cll you have. A doctor might be more comfortable waiting if someone has favorable genetics.
I think the main questions you might have for your doctor is when does he/she foresee treatment beginning for you, what treatment options you have and what treatment he recommends for you should treatment be indicated.
Your lymphocytes are still relatively low for a cll patient and lab tests can vary even over a short period of time, so your lymphocytes doubling time, if your other labs are good, might just be a one time anomaly. I am guessing your doctor will want to do repeat labs at some point before suggesting treatment to see if your lymphocytes are truly on a doubling path.
But I am no doctor and certainly not an expert on when to treat. I do think lymphocyte doubling becomes a bigger issue at higher numbers, such as going from 100 to 200 instead of 16 to 32. An infection you dont even know you have might have caused your lymphocytes to go up at the low lever you are at. Good luck with your visit.
If I may add to Cajunjeff. while there is that "doubling time in less than 6 month' rule, I had mine double at some point after a vaccine, and doctor said not worried (but did move next appt up to 4 months from the regular 6). And yes, at lower numbers, it's a bit easier to "double". What I am intrigued about is your 8.3 neutophils! Wow, that sounds wonderful. Never had, never heard of levels like that. Maybe it's common outside this community but in cll-ville, don't think so.
I had the exact same combination of results as you in April (although from higher WBC). Consultant didn't really care and then explained to me why it doesn't matter as all the other results were stable. My last checkup was a week ago and it WBC was stable again.
Not sure it's advice, maybe more that your consultant may not think it's even worth a mention
One thing I can tell you that will bring you some peace of mind is that the white cells didn’t double in three months. That is a good thing. What they look at is how you feel, if you have night sweats or tired etc. Until you see your doctor, try to relax
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