Hello everybody, I live in United States. I don’t have a CLL diagnostic. My lymphocytes have been above the normal range (1.1-2.7) from last year (2.92, 3,2, 2,87) . Only one time went down to normal. Before this started I only had high platelets for 8 years the rest of the numbers were normal. I got the bone marrow biopsy last year just 3 months before the lymphocytes issue. It was normal cellular. But the radiologist informed there was a tiny aberrant T cells population probably reactive. He recommended surveillance. Also ,a small bilateral plural effusion is seen in several MRIs I had for another reason from 2017 to now. Ct last year negative . The hematologist is not concerned but I’am. Can be this the change in my lymphocytes the beginning or the process for the disease? Can somebody tell me if this is the way the disease starts?
Hight lymphocytes and platelets : Hello... - CLL Support
Hight lymphocytes and platelets
CLL will not show on bone marrow as aberrant T-cells. Your lymphocytes are not above the normal, they are simply fluctuating within normal limits (1000-4800, depending on the lab) and this is perfectly normal. Much like our blood pressure varies throughout the day. Your lymphocytes will fluctuate as you are exposed to various things in your environment. It's elevated levels above the upper limits for an extended period of time that may be an indication of disease. And even then, it may only mean you have a low-grade infection you can't shake off.
T-cells are common in the bone marrow. "Probably reactive" doesn't have much of a meaning. As our body's immune system is activated, T cells becoming reactive is a part of this.
If anything in the bone marrow biopsy looked diseased, more testing would have been done. Without reading the exact report by the pathologist, my interpretation of what you are stating, is that you were told to just possibly re-test if you ever had other symptoms that might indicate the beginning of a disease process.
Our bodies have random "not normal" things happen. It's sustained aberrations, with symptoms, that indicate some sort of disease. Why did you have a bone marrow biopsy, anyway? The symptoms you have stated don't seem to be a reason for a doctor to order one. If a doctor suspected CLL, it would be pretty easy to order testing on blood.
Hi SofiaDeo, thank you for your reply. He ordered the bone marrow biopsy because my platelets were consistently high and they were thinking about Essential Thrombocytemia . But it was negative for that disease. Some months after it, actually last year in November the lymphocytes started to rise above the level . The hematology lab normal levels they use are from 1.1 to 2.7 for lymphocytes. Can you tell me how are the blood counts that can indicate the disease ?
As a result of the way limits are calculated, 5% of the population have healthy blood counts above or below the reference range. So you have a 1 in 40 chance of being healthy, but having a lymphocyte count on the high side.
To have a blood cancer, by definition, you must have a clonal population of blood cells. If your doctor was at all concerned that you might have blood cancer, they can order a flow cytometry blood test to check for blood cell clones. Lymphocyte counts can be high due to inflammation or fighting off infections. To be diagnosed with CLL, you need to have a B cell clonal count of at least 5.0.
Finally, if you have a growing clonal population of lymphocytes in your bone marrow, that gradually impacts on your ability to replace the several hundred billion worn out blood cells you need each day, most of which are platelets and red blood cells. So you are likely to see platelet and red blood cell counts trending down over time if there's a growing clonal population in your bone marrow. That eventually manifests as easy bruising and anaemia respectively.
Neil
Hi Neil, thank you for your response. I wanted to add that I also got a Flow S when I had the bone marrow a year ago and two NGS panels . One from the bone marrow and one from the blood. The one from the bone marrow detected these mutations . I already ruled out of Fancony anemia for the FANCE mutation because I have only one mutation so I’m a carrier , but for the disease you need two . But I don’t know about the other mutations. For the one I got from the blood I was positive for TCL1 mutation and the pathology stain in the bone marrow was positive just for a few scattered Bcells . So the doctor not considered malignancy. All of this happened before my blood count showed high lymphocytes.
Those tests aren't done for CLL, which is the most commonly diagnosed adult leukemia/lymphoma in the Western world, with a median age of diagnosis of around 70. Also your lymphocyte count isn't high in the leukaemia world. With CLL, there's no lymphocyte count threshold to start treatment. We have some members with counts of several hundred thousand still in watch and wait. CLL specialists instead monitor lymphocyte doubling time, taking closer interest after the lymphocyte count has exceeded 30.
By all means keep an eye on your blood test results to be on the alert for trends, but if no clonality has been detected and your lymphocyte count is just around the upper normal limit, you don't have leukemia.
Neil
I will do that , thank you
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