Blood cell size and shape data?

[sbs_patient]

I've now been on Rux/Jakafi for about six weeks. My blood count numbers haven't changed in the last two weeks, so may be stabilizing at or near normal levels. I'll be more confident about this after my next blood work in two weeks.

That being said, I wonder if anyone can enlighten me as to the meaning, interpretation , and possible significance of the blood count results that relate to cell size (MCV, MCG, MCHC, RDW, MPV), distribution (percentages and absolute numbers for neutrophils, lymphocytes, monocytes, eosinophils, basophils, metamyelocytes) and shape (anisocytosis, elliptocytes, hypochromia, microcytosis, reactive lymphocytes). How do any of these relate to PV or other MPNs?

Thanks, Stephen

[hunter5582]

That is a very complex question that would need a very detailed answer. You are correct to think that all of the blood cell values you listed are related to PV and the treatment for it. Ultimately you will need to talk to your MPN care team about your current status. It really helps if you have a basic understanding of the terms so that you can speak the same language. Here are a couple of resources that may help.

Reading your CBC

youtube.com/watch?v=Xj_yE1p...(Not working as expected?)

Polycythemias

youtube.com/watch?v=pWGRT17...(Not working as expected?)

Erythropoiesis Part 1. see link to part 2

youtube.com/watch?v=kcnOXlr...(Not working as expected?)

I find it help[s to take notes and use the rewind button a lot.

Once you have a basic understanding of what all these terms on your CBC mean and how they relate to PV, you can have a more informed discussion with your MPN care team about what this all means in your case. Suggest you request a 30 minute appointment for this as it takes some time to review.

Hope that helps.

[sbs_patient in reply to hunter5582]

Thanks for your reply and for the links; the presentations are definitely interesting and informative. I'll ask about these numbers at my next hematologist appointments. My local hematologist doesn't exactly inspire me with confidence, so I don't expect to learn much from him. The MPN specialist is much better, but she's in Philadelphia, about 180 miles from here, so a visit needs significant planning. I don't think there are any MPN specialists closer than 150 miles or so.

[hunter5582 in reply to sbs_patient]

I think the next closest MPN Center is in Baltimore at Johns Hopkins. There may be some other MPN expert docs closer on one of these lists but i would not change if you found a doc you like. Given what your questions are, i would think you could set up a tele-video visit. This can work quite well for some issues.

pvreporter.com/mpn-speciali...

mpnforum.com/list-hem./

[EPguy]

For the MCV etc, my Dr does not follow these closely as he considers them of low priority. That doesn't mean for others it's never important, Dr advice here is what matters.

Here are some plots of a few of them for me. They were way out of range, this corresponds to my HU therapy period. HU is known for this and as Hunter has noted before, it's one way to know whether we are taking the HU. Since switching to Besremi these counts have normalized.

In PV neutrophils are often high, it was a key reason for my Dx of PV rather than ET. Strangely my Neut, HCT etc got better before starting therapy. PLT did not till the HU.

Some of the "shape" items you note seem to relate to anemia, which we know can be connected to PV.

MCV etc

[sbs_patient in reply to EPguy]

Thanks for your reply and comments. I'll definitely ask about these findings at my next hematologist appointments.