New to the group. Should I worry concerning my latest blood results?

[povhgc]

New to the group. First post even if I regularly read what is posted.

Dx in March 2023. But CLL for at least 2 years. Unmutated, triso 12 and q (14,19).

On W&W. 53 years old.

I had an appointment with my Cll doctor one month ago and a bit worried.

Wbc 48 000

Monocytes 12000

ALC 29 000

LDH 550

I understood that in cll only lympho increased. What worries me here: high level of mono and Ldh.

Had a coloscopy in September. No issues.

My cll doctor wants me to have a blood test in January to recheck mono.

Also some tinnights that can be annoying.

Any toughts on this? Thanks for your support. I learned a lot in this group and sorry for my English. Not my mother tongue😉

[lankisterguy Volunteer]

Hi povhgc,

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Welcome to the club none of us wanted to join. Your English is far better than my French, and you seem to have a good understanding of your blood tests.

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I'm not medically trained, but it looks like your CLL is the source of the ALC at 29,000, the LDH and WBC may need further "differential diagnosis" en.wikipedia.org/wiki/Diffe... to see what is triggering more white blood cells beyond the lymphocytes (there are 4-5 others with Neutrophils ANC being the most numerous). Perhaps an infection of some type.

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When you have time, you can use the Pinned Posts like: healthunlocked.com/cllsuppo...

to climb the learning curve to understand your CLL better, and preparing a list of inciteful questions for discussion with your doctors after your next blood test in January may reveal much more information in French.

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Len

[povhgc in reply to lankisterguy]

Thank you Len for your reply! I will read the different links that you sent

[cajunjeff]

Hello povhgc, nice to see you posting.

Rising ldh can be a sign of advancing cll. I doubt anyone can give you much more helpful information beyond that though, based upon one set of lab work.

With cll our doctors typically are more interested in trends over time as opposed to a snapshot in time provided by one lab result. By way of example, if over the past year your wbc has gone from 12000 to 48000, that would indicate your cll is moving fast and treatment might be indicated. It’s the same with ldh, hemoglobin, platelets and some other results. If your ldh has suddenly jumped after being stable for a while, your doc might want to see why.

On the other hand, if your wbc went from 40000 to 48000 over a year, that would be indicative of more stable cll. Indeed if your wbc hovered around 100k for a year, that might indicate stable cll as well.

To my understanding, while high ldh can be associated with faster growing cll, I do not think elevated ldh on its own is an indication to treat under current iw-cll treatment guidelines. Our markers that indicate treatment, like low hemoglobin, low platelets, or increasing nodes, often move in tandem when our cll is active.

Your doctor will probably know best as he/she will have access to your labs over time and can look for trends. I do recall reading somewhere there is a correlation between trisomy and high ldh. The good news is that whenever you need to treat, treatment will almost certainly bring your ldh back into normal levels. Good luck to you.

[povhgc in reply to cajunjeff]

Thanks for your reply. Hemoglobine seems rather stable at 15. since March. Platelets at 260. Small decrease. Let s see what will happen during the next appointment with my Cll specialist.

[Big_Dee]

Hello povhgc

Welcome to the site of hope.

[scryer99]

Keep an eye on the numbers, but no major alarms. I was at similar age and progression.

Doubling rate of ALC at this point will be somewhat indicative of how things might progress. I was doubling at 3-4 months at that juncture, and went about 12 months from your ALC count to treatment, although I had other symptoms later in the progression that caused me to enter treatment. They should not send you to treatment just on ALC count.

My monocytes bounced around quite a bit. Didn't seem to matter much in the end.

[povhgc in reply to scryer99]

Thank you so much for your reply. I will keep an eye on the numbers. I have a very good doctor and will discuss with him early January my next blood test results. Apparently will be put on O+V when the treatment needs to begin.