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Nucleated RBC - Should I be concerned?


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#1 Melanie

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Posted 24 July 2012 - 04:48 PM

Just got lab results back and had nucleated rbc show up for the first time. It's only 1/100 wbc, but research results were scarey even at that low measurement. Anybody had any experience with these?

Thanks, Melanie


Dx - 05/2011; PCR: 15.04; Fish: 87% Slow responder due to pancytopenia. Current - Bosulif - Nov: 2012, Mar 2016 lowered to 300 mg. 07/16 back to 400 mg. Clinical trial drug, Promacta, Feb 2013, for low Platelets.
CyCR - Aug 2014, Positive for 1 chromosome Sep 2015. PCR: 12.77 in Oct, 2012 to 0.04 (MDA) in Mar, 2016. 4/2016 - 0.126 (Local lab (IS); 05/2016 - 0.195 (local); 6/2016 - 0.07 (MDA); 7/2016 - 0.03 (local) 9/13/2016 - 0.16 (MDA); 9/26/2016 - 0.31 (MDA); 11/2016 - 0.012 (local); 01/2017 - 0.24 (MDA); 04/2017 - 0.09 (MDA); Cytogenetics show der(1:7)(q10;p10)7 chromosome mutation. Repeat of Sep 2015. PCR - 6/2017- 0.035 (local); 10/2017- 0.02 (MDA)

#2 Pin

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Posted 25 July 2012 - 07:33 AM

Is this the same as a target cell? I had this show up in my last test and I was a bit freaked but the doctor wasn't worried about it at all.


Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).

Commenced monthly testing when MR4.0 lost during 2012.

 

2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)

2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)

2015: <0.01, <0.01, <0.01, 0.013

2014: PCRU, <0.01, <0.01, <0.01, <0.01

2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01 

2012: <0.01, <0.01, 0.013, 0.032, 0.021

2011: 38.00, 12.00, 0.14


#3 Trey

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Posted 25 July 2012 - 09:46 AM

End stage red blood cells have no nucleus, but the higher level cells that make them do have one.  Nucleated RBCs are those which have not made the final division(s) and/or have not shed the nucleus.  Normally they stay in the marrow until they shed the nucleus.  Overall it is not much of an issue at those levels.  It is another sign that blood quality has not yet returned to normal after the pummelling of the blood making system by the CML. 

If you care about why and how RBCs shed their nucleus:

http://www.wi.mit.ed...08/hl_0210.html

Pin: Not the same as a target cell, although a target cell is an abnormal RBC that also shows something about blood quality:

http://en.wikipedia....iki/Target_cell



#4 Melanie

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Posted 25 July 2012 - 12:24 PM

Thanks Trey. Appreciate your wisdom and willingness to share. So much to learn. It seems I finally get one segment of the blood lines back to normal and something else pops up.

Do target cells show up on lab reports? 

I know TKI drugs can inhibit blood quality returning to normal, but can they also damage the "normal" blood making system in the marrow similar to the CML?

Melanie


Dx - 05/2011; PCR: 15.04; Fish: 87% Slow responder due to pancytopenia. Current - Bosulif - Nov: 2012, Mar 2016 lowered to 300 mg. 07/16 back to 400 mg. Clinical trial drug, Promacta, Feb 2013, for low Platelets.
CyCR - Aug 2014, Positive for 1 chromosome Sep 2015. PCR: 12.77 in Oct, 2012 to 0.04 (MDA) in Mar, 2016. 4/2016 - 0.126 (Local lab (IS); 05/2016 - 0.195 (local); 6/2016 - 0.07 (MDA); 7/2016 - 0.03 (local) 9/13/2016 - 0.16 (MDA); 9/26/2016 - 0.31 (MDA); 11/2016 - 0.012 (local); 01/2017 - 0.24 (MDA); 04/2017 - 0.09 (MDA); Cytogenetics show der(1:7)(q10;p10)7 chromosome mutation. Repeat of Sep 2015. PCR - 6/2017- 0.035 (local); 10/2017- 0.02 (MDA)

#5 Trey

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Posted 25 July 2012 - 05:15 PM

Such things show up on blood smears reviewed by microscope.  The CBC is an automated test. 

CML itself affects blood quality in a big way.  Then the combination of CML and TKI drugs can together negatively affect blood  quality.  Over time as the CML is brought under control, the body compensates for the remaining downside impacts on blood quality in most people, but some will continue to have issues over the longer term. 






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