Blood test results

[Feavers]

Hi w and w six years, numbers I am concerned about lymphocyte count 72.7 platelet 123 rbc 4.38 monocyte 2.5 wbc 79,2 slowly increased every 6 months love to know your feelings, am I getting near treatment, thanks in advance

[SofiaDeo]

If you start reading the Pinned Post section, there are informational articles about what is considered significant in determining treatment/is one approaching it.

The information you have stated, is not enough to even attempt an answer. Some of the numbers listed aren't relevant, other things are missing. Please consider reading/learning items in the Pinned Posts, to at least know the things doctors look at before deciding if one is nearing treatment or not. Then I & others could comment on "are you looking like you are getting near treatment or not", after you then give us the appropriate things docs generally consider.

[Feavers in reply to SofiaDeo]

Thanks for the response 👍

[Newdawn Administrator]

Hi Feavers,

This is a good explanation of treatment indicators. I’m presently on holiday so hope this works;

Criteria for treatment;

‘B Symptoms (there are no A symptoms)

Weight loss >10% of body weight in previous 6 months

Severe fatigue (ambulatory and capable of all self-care but unable to carry out any work activities

Fevers >38°C for at least 2 weeks without evidence of infection

Drenching night sweats for more than a month without evidence of infection

Evidence of progressive bone marrow failure manifest by low blood counts (cytopenias) including anemia (low red blood cells) or thrombocytopenia (low platelets)

Massive or symptomatic splenomegaly (enlarged spleen)

Massive lymph nodes or clusters of nodes (>10 cm) or progressive or symptomatic lymphadenopathy (enlarged lymph nodes)

Autoimmune Hemolytic Anemia (AIHA where the body attacks its own red cells) and/or Immune Thrombocytopenic Purpura (ITP where the body attacks its own platelets) that is poorly responsive to steroids or other standard therapy

Rising ALC with an increase of more than 50% over a 2-month period or a lymphocyte doubling time (LDT) <6 months. If ALC is <30,000, LDT should not be used as the only criterion for beginning treatment.

The last indication for treatment, namely a rapidly rising ALC is controversial.

Please note there is no absolute level of ALC that demands treatments.’

Active disease should be clearly documented to initiate therapy. At least 1 of the following criteria should be met.

Evidence of progressive marrow failure as manifested by the development of, or worsening of, anemia and/or thrombocytopenia. Cutoff levels of Hb <10 g/dL or platelet counts <100 × 109/L are generally regarded as indication for treatment. However, in some patients, platelet counts <100 × 109/L may remain stable over a long period; this situation does not automatically require therapeutic intervention.

Massive (ie, ≥6 cm below the left costal margin) or progressive or symptomatic splenomegaly.

Massive nodes (ie, ≥10 cm in longest diameter) or progressive or symptomatic lymphadenopathy.

Progressive lymphocytosis with an increase of ≥50% over a 2-month period, or lymphocyte doubling time (LDT) <6 months. LDT can be obtained by linear regression extrapolation of absolute lymphocyte counts obtained at intervals of 2 weeks over an observation period of 2 to 3 months; patients with initial blood lymphocyte counts <30 × 109/L may require a longer observation period to determine the LDT. Factors contributing to lymphocytosis other than CLL (eg, infections, steroid administration) should be excluded.

Autoimmune complications including anemia or thrombocytopenia poorly responsive to corticosteroids.

Symptomatic or functional extranodal involvement (eg, skin, kidney, lung, spine).

Disease-related symptoms as defined by any of the following:

Unintentional weight loss ≥10% within the previous 6 months.

Significant fatigue (ie, ECOG performance scale 2 or worse; cannot work or unable to perform usual activities).

Fevers ≥100.5°F or 38.0°C for 2 or more weeks without evidence of infection.

Night sweats for ≥1 month without evidence of infection.

Newdawn

[Feavers in reply to Newdawn]

Thanks for the response, have a good holiday enjoy

[cajunjeff]

Feavers, our doctors usually look for trends over time more than they do a single point in time blood test to decide when to treat. Hemoglobin below 10 and platelets below 100 are considered as indications to treat, but even then, if those numbers have been stable for a long time, treatment might not be indicated.

The labs we look at most are lymphocyte counts, hemoglobin and platelets. If you can give some idea how these numbers have trended for you over the last couple of years, you might get more helpful feedback.

Neither your lymphocyte count of 79 or platelets of 127 are, in and of themselves, an indication to treat. If your lymphocytes have doubled in 6 months, that is one indication to treat. If your platelets have been rapidly falling, that can be a concern too. You could be under a 100 with platelets on your next labs or stay stable around 127 for many more years, no one can say. But if your platelets shave been steadily dropping over the last few labs, they will probably keep trending down.

Trends over time tell more of the story than a single point in time.

[Feavers in reply to cajunjeff]

Hi I will be keeping an eye on the platelets thanks for the response