Smudge cells

[Buffy-1]

Is it better to have few or many smudge cells on the light microscopy test. My husband bounces back and forth between the two. Blood drawn every 3 months. And google didn't help because one answer said few and one said many?

[AussieNeil Partner Administrator]

The more smudge cells the better. It's a sign of reduced cell membrane strength, which is why they break (smudge), in a blood smear. See this Mayo Clinic paper about their potential use as a prognostic marker.

pubmed.ncbi.nlm.nih.gov/174...

Independently validated 7 years later by Indian researchers:

pubmed.ncbi.nlm.nih.gov/246...

Neil

[Buffy-1 in reply to AussieNeil]

Thank you.

[Edalv in reply to AussieNeil]

Neil, thanks for the information. I always thought that having smudge cells was a negative indicator. This is very useful information. 🙏

[Skyshark]

Smudge cells are expected to be present and are frequently taken as an indicator of CLL when ALC is high but it may not be.

This case of CLL was re diagnosed as MCL after biopsy. CLL doesn't (usually) have high Cyclin D1 and Ki-67 proliferative index should be low(er).

ncbi.nlm.nih.gov/pmc/articl...

Smudge cells make getting an accurate ALC difficult, a large number may result in a low differential count.

academic.oup.com/labmed/art...

[DianeSH]

I watched a video of the founders of CLL, both patients themselves, and one described a smudge cell as kind of squashing a rbc when they put the top on the slide to examine under the microscope. He said it was the technicians fault (kidding)....it just happens sometimes the way they put the slide together....