Poikilocytosis

[ZimmC]

Does anyone know what if any implications Poikilocytosis has on CLL?

[SofiaDeo]

The only time I had it, I was taking venetoclax and had started a standard dose statin. The statin unexpectedly got potentiated/was too much for me, my total cholesterol dropped to 138 and I had other signs of RBC dysfunction. Decreasing the statin got my cholesterol level back up, and my RBC's normalized.

I think docs sometimes forget cholesterol is an integral component of many cells in the body; in this instance, apparently I didn't have enough cholesterol around to make normal RBC membranes. There can be cholesterol "too low".

As far as CLL itself, it may just be your bone marrow is not able to make normal RBC's if the CLL has infiltrated the marrow.

[ZimmC in reply to SofiaDeo]

Thank you for the information. I’m waiting for a response from my doctors office, hoping for some more clarity. My blood work last year didn’t show it, 6 months ago it showed up as 1+ and now again 1+. Would you happen to know if/when taking BM biopsy would be possibly needed, not necessarily because of this result but any other information to indicate that it might be needed?

[SofiaDeo in reply to ZimmC]

Well, unless other RBC parameters are changing indicating a probable anemia, it really may just be the CLL. Patients with MDS (sometimes thought of as "pre-CLL) may get it. If you aren't having symptoms, and other parameters are normal, it just may be due to ramdom stress from the CLL. Since BMB isn't "necessary" for routine monitoring, I would think this lab value is something the doc will simply note. 1+ is the lowest level of abnormality. Unless there are other abnormal tests and/or you are having symptoms, you probably don't "need" a BMB. Some sort of CLL infiltration in marrow is a given with this diagnosis; unless you personally are pushing for a BMB, the doc may not.

For me, my platelets are the cells being abnormal most of the time, they seem to hover around 100. I don't have bleeding problems at this number. No one has wanted to do a BMB to investigate further. Some of us get low neuts, or other types of anemia. Unless there are other signs/symptoms concerning you/your doc, this may just be "what your CLL variant happens to do."

[ZimmC in reply to SofiaDeo]

Thank you for all the info. My platelets/rbc/hemoglobin have been declining but still within normal range. I will try not to think too much about it, and just keep moving forward. It’s always a struggle for me, I tend to overthink blood work results, something I need to be better at letting go.

[Jm954 Administrator]

Poikilocytosis just describes the red cells as irregularly shaped and has no bearing on your CLL. This is most likely an artefact caused by processing or storage of the sample.

[ZimmC in reply to Jm954]

Thank you