6 replies to this topic

[djm]

I've noticed alot of people say that when they were diagnosed, their platelet counts were high.  What does it mean if ones platelets weren't?

For me, at diagnosis, my platelet count was just below normal at 136k.  Since diagnosis, I've been in the normal range where the highest number I've had was 287k.

Just curious if that means anything.

[Trey]

CML can have either high platelets or "not high" (normal or low) platelets at diagnosis.  Although leukemia is generally a disease of the white blood cells, the originating leukemic stem cell makes all the types of blood cells.  But only WBCs have the Philadelphia Chromosome, so only they can be truly called "leukemic".  But the red blood cells and platelets are also affected by the leukemic cells that were their ancestors, which is why they are often abnormal in some way or another.  But generally, not having high (or low) platelets is just one less thing to be concerned about.   

[CallMeLucky]

My platelets were in the normal range, on the higher end, but still normal.  I imagine if I had gone longer before being diagnosed they would have climbed.

[scuba]

Trey - Just to be clear. Which Stem cell does CML originate? If it originates in the top stem cell - then all descendants would have the Philadelphia Chromosome (lympohoid line + Myeloid line). If it is only the Myeloid stem cell that becomes defective, then what you wrote above is accurate.

Which is it?

According to this source: http://bloodjournal..../4758.full.html

Ph+ cells do seem to be eliminated naturally on the Lymphoid line through differentiation leading to T-cells and NK cells demonstrating few Ph+ cells (or none). Only B-lymphocytes continue with the Ph+ chromosome.

[Trey]

CML starts at the highest level.  So as I said, "the originating leukemic stem cell makes all the types of blood cells" so all blood cell lines are affected (myeloid, lymphoid, red lines).  As you can see from your diagram, the "red line" cells are not called "red blood cells" or "platelets" until they have shed their nucleus.  So they cannot have a Philadelphia Chromosome if they do not have a nucleus, although their progenitors do.  Maybe that wasn't clear enough.  The only end-stage blood cell with a nucleus is a WBC.

The article you cite is ancient, and the lab equipment may not have been sensitive enough to detect the leukemic T-cells.  Lymphoid WBCs are also leukemic in CML, but usually in lower numbers.  That may be due to the body slowing down the lymphoid progenitors to reduce the WBC count.

[pamsouth]

Trey/Scuba,

Quote "Lymphoid SBC are also leukemic in CML."  Question, if lymphoid WBC are also leukemic, then why do we call CML Myeloid, why not Chronic Myeloid, Lymphoid Leukemia?

Thy Lymphoid WBC are nucleus right, so that means they also have PH+ BCR/ABL??   Just not as many?

PAMSOUTH

[djm]

Interesting info.  Thanks Trey.