raised lymphocytes

[FranceMary]

suddenly my lymphocytes have jumped. the doctors are searching for infection.

[AussieNeil Partner Administrator]

Some additional context will help members better support you. (Adding this information into your bio from this link healthunlocked.com/profile/... will save you from having to provide it in future.)

You recently mentioned being treated with venetoclax. Are you on any other treatment drugs for your CLL? Did you recently cease taking venetoclax, etc., if so when? What were your recent lymphocyte counts and when were they taken? Have you had a CRP test done to check for inflammation/infection?

Neil

[FranceMary in reply to AussieNeil]

Current medications:

Venetoclax 400mg once daily

Co-trimoxazole 960 mg three times a week from GP

Aciclovir 400 mg twice a day from GP

Movelat gel for painful knee

Vitamin D supplements - colecalciferol 1600 units OD

Abdominal pain

Hypercalcaemia

Patient Active Problem List

Diagnosis

• Chronic lymphoid leukaemia, disease

• Chronic obstructive lung disease

• Rheumatoid arthritis

• Abdominal pain

• Concerned about appearance of fingernails

• Hypercalcaemia

Results

Value Date

Haemoglobin 118 03/07/2024

White Cell Count 9.0 03/07/2024

Neutrophils 2.27 03/07/2024

Lymphocytes 5.28 (H) 03/07/2024

Platelet Count 140 03/07/2024

Creatinine 57 03/07/2024

Adjusted Calcium 2.67 (H) 03/07/2024

Total Bilirubin 5 03/07/2024

Aspartate Transaminase (Aspartate Aminotransferase) 53 (H) 03/07/2024

Alkaline Phosphatase (ALP) 76 03/07/2024

Alkaline Phosphatase (ALP) 76 03/07/2024

Gamma-glutamyl Transferase (GGT) 12 03/07/2024

Vital signs:

03/07/24 15:30

BP: 125/76

Pulse: 60

Resp: 16

Temp: (!) 35.5 °C (95.9 °F)

SpO2: 99%

[AussieNeil Partner Administrator in reply to FranceMary]

Your blood counts look good. Your lymphocyte count is only just over the threshold of 5.0 for a CLL diagnosis, but how low did it get prior to your last blood test? What were your last few lymphocyte counts and their dates please?

Your Aspartate Transaminase (AST) and calcium are probably only just over their upper reference limits, so I doubt you doctor would be concerned about them. Temperature isn't a good guide to infections when we have CLL, particularly during treatment when neutropenia is likely, though your neutrophil count is adequate.

Remember that with CLL, it's trends that are important.

Neil

[22011 in reply to AussieNeil]

Could you explain what you mean by temperature isn't a good guide to infections with CLL?

[AussieNeil Partner Administrator in reply to 22011]

Because CLL compromises your immune system, you don't necessarily have a high temperature when you are very ill. That's probably more the case when you are neutropenic - you can have an infection without running a fever. That's one reason I asked if your doctor had arranged a C-Reactive Protein (CRP) test to check for inflammation or illness.

Neil

[FranceMary in reply to AussieNeil]

I dont think I have had a C-Reactive Protein (CRP) test to check for inflammation or illness. I wasn't offered it even though I feel something is wrong. I have a sore throat and a spot on my nose and itchy ears and pains in my tummy. I have had a CT scan (no results from that yet) and will have an endoscopy at the end of July. Coul;d you read the print scan of the High lymphocytes? It is a sudden jump. I have been stable for 2 years.

[AussieNeil Partner Administrator in reply to FranceMary]

If you have attached a scan of your past lymphocyte counts, I can't see it. Try replying again with the scan photo attached. (It needs to be a photograph or scan image file, with a jpg or png extension for this site to accept it. (You should be able to see if the image attached.) Otherwise you could just list your past lymphocyte count results and dates.

You might also wish to edit this post so that it is private to our community or at least black out any identifying information on your scanned results. See healthunlocked.com/cllsuppo... and replies for how to change this if you wish to do so.

Neil

[22011 in reply to AussieNeil]

Thanks for that answer (BTW I am not the person who made the original post) My doc says at every visit, if I ever get sick I must have an antibiotic immediately. I've never actually been sick since CLL -- diagnosed in 2006 --but I recently developed bronchitis with a low grade temp that hit 99. So I called my GP and reminded her I was supposed to get an antibiotic right away. She gave me azithromycin Z pac which improved me some but after a week I was still congested and coughing. She then thought I had pneumonia so we got an X-ray but I was clear . She gave me amoxicillin/Clavo for 7 days. At the end of total 14 days I was over the bronchitis. But now I know from your post that if I am sick and don't show a temp I should still get treated right away. Interestingly, I have never had an allergic reaction to antibiotics but this time 4 days after stopping the amoxicillin I broke out in a full body rash with prickly itching. Being a Saturday I had to go to the ER where I never mentioned the amoxicillin when they asked what drugs I was on because I was off it for 4 days and didn't think to associate it with the rash. They treated me with 4 different IV drugs and then added Ativan when I wasn't improving fast enough. So I was discharged when the rash seemed to be fading a little and the prickly itching subsiding some. Taking Benadryl, Decadron and Pepsid at home. This is the third day and I am 98% free of the allergic reaction. After googling amoxicillin and reading about frequent rashes I called back the ER nurse. She said they wouldn't have treated me any differently anyway, and claimed that amoxicillin reactions show up quickly when you start the drug. According to Dr Google and my sister that isn't true. My sister said she frequently gets a delayed rash especially if it was a short course of treatment. Appreciated your input.

[sunsetssr in reply to 22011]

Have you ever thought the skin reactions is due to your cll? It is called Cytoxin Strom. It happens when your body is under stress of illness, some environmental issues like taking hot shower or reaction to any new drug used.

It has happened to me after MRI,PET Scan ,after the use of the contrast media used or when I was on oral Chemo. etc.

[22011 in reply to sunsetssr]

Thanks, I'll keep an eye out for that but it seems very coincidental to the amoxicillin which has this known side effect. Also my CLL is not very active right now.