Absolute Lymohpcyte Count (ALC) and other metrics

From the CLLSA website "To get the Absolute lymphocytes number, multiply the WBC by the percent lymphocytes. For example, if the WBC is 30.0, and the lymphocyte percent is 65%, the absolute lymphocyte number is 30.0 X 0.65 = 19.5"

I have three questions:

1: The maths is easy, however I have alot of metrics from the hospital (33) but not a lymphocyte percent, which, I think means cant calculate ALC, unless there is another way?

2: Anyone know if different hospitals use different measurements as normal?

3: I have MCHC, MCH and MCV numbers - there isnt a 'normal range' on the CLLSA site, whilst they may or may not be relevant once I've got the number I'm curious.

Some of the 33 are not on the list on CLLSA site, I guess they are probably part of standard blood test that might be relevant for other problems.

All of which reminds me of another question...

I sometimes see numbers like 200K written in the blogs/questions. In my business K is 1000 (1024 actually). So, that suggests to me 200,000, that's huge and I think I'm missing a bit of knowledge to plug a huge gap in my understanding of the figures because my numbers the absolute biggest was LDH at around 500 regardless of what they are.

rob

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  • When discussing white blood cell count (WBC) it is for a micro litre... so the K means 1000.

    The alternate is the number of Cells X 10 to the 9 power per litre...

    We make a billion white blood cells in a day...so the numbers are big...

    There should be an absolute lymphocyte count (ALC) in Europe it may be called TLC. It is in a setion called 'differentials'. Often they take two hours to process in th lab so unless you waited two hours after a blood test to see your doctor they won't be on the report you got. Your report may not be complete in other words...

    I get bloodwork done a few days in advance of a consultation then my reports are complete when I see the doctor and receive a copy...

    ~chris

  • Hi Rob Chris gave me a recent lesson on calculating ALC in his recnt blog: "Why we need to track the absolute lymphocyte count (ALC) not white blood cell count (WBC)" cllsupport.healthunlocked.c... there are a few usefull links in the thread. i also find it all confusing.

    It seems mistakes have been historically made with the decimal point in the calculation.

    Good to see Chris has answered you, i had a few thoughts.,

    1: >>;The maths is easy, however I have a lot of metrics from the hospital (33) but not a lymphocyte percent, which, I think means cant calculate ALC, unless there is another way?

    Are you already given an Absolute Lymphocyte count within your results ?

    2:>> Anyone know if different hospitals use different measurements as normal?

    I asked this of my own consultant two days ago as my counts vary between my two doctors and health authorities. he confirmed different type machines and methods may be used which can cause a variation in counts.. Looking at some reference ranges I see variations between countries?

    3:>>; I have MCHC, MCH and MCV numbers - there isnt a 'normal range' on the CLLSA site, whilst they may or may not be relevant once I've got the number I'm curious.

    Thanks for pointing this out, I am unsure why they are not entered??

    Doing a quick search patient.co.uk/doctor/full-b... these were the figures: :

    Mean cell volume (MCV) - guideline normal values: 77-95 fL.

    Mean cell haemoglobin (MCH) - guideline normal values: 27.0-32.0 pg.

    Mean cell haemoglobin concentration (MCHC) - guideline normal values: 32.0-36.0 g/dL.

    ...

    4. >>;I sometimes see numbers like 200K written in the blogs/questions. In my business K is 1000 (1024 actually). So, that suggests to me 200,000, that's huge and I think I'm missing; a bit of knowledge to plug a huge gap in my understanding of the figures because my numbers the absolute biggest was LDH at around 500 regardless of what they are

    In the UK we get our number WBC counts in Cells X 10 to the 9 power per litre . wheres over the pond they use the microlitre hence thousands of cells per micro ltre.

    That is why your LDH figures apear the biggest. Good news is they fall in the normal ranges.

    normal LDH reference range 313-618 cllsupport.org.uk/uybresult...

  • Good one Nick...

    Just wanted to mention Labs on Line...is has a comprehensive number of lab tests...

    If you are in the UK be certain to select the Union Jack flag...in the US or Canada the Stars and Stripes...this changes the various differences in nomenclature and volumes used.

    UK ..... labtestsonline.org.uk/

    US/CANADA ..... labtestsonline.org/

  • Wow, that looks a good website, thank you Chris. I can see myself on that for several evenings.

    I just found a random fact that made me sit back and think "Over 7000 people are diagnosed with leukaemia annually in the UK, making it the 10th most common cancer in men and 9th in women"

    The people talking on this blogsite is just a small percentage of those with Leukaemia, even in UK, just checked directory entries, 306 members! Not even 4.3% of those diagnosed in one year! I realise CLL is only part of the 7000 but nonetheless.

    rob

  • Here is a chilling fact... 12 people die of CLL everyday in the U.S.

    Here are the most recent U.S. stats....

    seer.cancer.gov/statfacts/h...

  • UK CLL annual diagnosis is not far short of half that total 7000. Yes we are only the tip of the iceberg in the group when you add the previously diagnosed. There are 30k plus of us in the UK. We should have a much larger voice.

    Uk statistics can be obtained from the Cancer research website. remember that these represent a group and mean/averages and do not represent an individual or their specific chances . We could be anywhere in the pyramid.

  • I love the 'Median isn't the Message' by Stephen Jay Gould on cancer and statistics

    Video

    Text

    people.umass.edu/biep540w/p...

  • I think I do too now, thanks for this .

  • That is an impressive video, thank you for sharing. Listened to it twice so far, really quite inspiring.

    I'd interprt it like this, statistics describe what has happened in the past, with changing world we dont have to conform to the past, it is our rsponsibily to improve on the past ...rob

  • Very interesting conversation and mirrored a little in my discussion with Hairbear on a blog on the CLLSA blog on this site.

    I am getting the ALC absolute number, not the percentage. Yes, as long as you have AWC and either ALC or L percentage, it is easy to get the one you are missing (ok, I admit my science background helps to make it easy...). Indeed my consultant (I think...) is of view percentages are a bit of a red herring (and as my percentage is 70%, I was struggling with the concept of doubling....but discussion with Hairbear has stimulated a Doh!-moment on my behalf): absolutes/trends are the key for a basis of discussion with the patient and treatment is patient-discussion-driven, not numbers driven.

    I too was totally confused by the 200k number...until I read above. It seems US / UK measurements are different and the 200k is US-unit number: being in UK I am indeed getting the x10 to the power of 9 number and the 200k number was baffling. What is the UK number?

    What is interesting and difficult is the range of blood info we get, not only by the looks of things a UK/US difference (down to units of measurement), but also with in the UK we are getting different info/measures. This leads (certainly in my case) to I think unnecessary difficulties in understanding them when you are relatively new to CLL.

    Should there be a clear standard core of info the entire community settles on (might have to be different in US and UK, but only around unit of measurement)? Is it easiest to understand absolutes around red/white cells and their sub-components and haemoglobin? I think that is what I will focus on for simplicity.

    Consultants will want their extra info that will vary (helps innovation in treatments, so this is very important) and if they shared that with a basic standard core, it would help us start to understand what is going on within our bodies: we can then better progress to more advanced understanding.

    Andy

  • Well, I had a bit of a 'doh' moment today with my Consultant. I asked how I could work out ALC. So, we looked at the spreadsheet he send me and said 'there'. Heading was LYM. I'd tried all combinations of ALC, TLC and xLC. So, now I've more graphs to plot :-)

    I think I'd been lulled into a false sense of knowledge as all the other column headings matched up with the table here cllsupport.org.uk/uybresult...

    Just in case anyone else is looking in future and cant find ALC or TLC check for LYM. I guess it will depend on the hospital and the format you get your results in.

    rob

  • Thanks for making that clear Rob. Other than your "doh" moment I hope it went well.

    LYM- Lymphocytes has always been available on my blood results from the two different health authorities I receive care from. I often ask about them when I telephone the GP receptionist for results of different tests as a CBC/FBC is normally included.

    I am not sure who still has to calculate their own? Is this a throw back to earlier years??

  • Hi Hairbear, Not sure who has to calculate their own. My main confusion was with the actual wording, looking for wrong thing and totally ignoring the obvious. I note that in the spreadsheet he sent it is LYM, looking back at some of the paperwork it is LYMPH. I have to stop being so literal!

    My results were good, so happy day

    rob

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