6 replies to this topic

[August1]

Hi everyone,

In my last CBC with Diff I can see a lot of information (all is normal) but don't see any reference specifically to blasts. Would this normally be shown in the report and could blasts be present even when counts are normal?

Thanks,

Bill

[LLawrence]

My lab's cbc report doesn't show a percentage or number of blasts unless they are present.  They don't show up on the automated part of the report (the automated cbc machines don't seem to show them), but at the end where the description of cells is located (done by a human).  I hope this is true for your lab as well.

LL

[Trey]

Generally, blasts should not be detectable on the CBC.  If blasts are detected, it is noted on the CBC.  If absent, there is no reference to blast count. 

[August1]

Thanks for the replies. So I guess in this case I can assume no blasts, which is a good thing!

[August1]

Hi Again,

Hope you are all doing well.

As I processed my way through my last report, I did also notice a few things in the report and would appreciate feedback if you have any.

They ran a flow cytometry report for about 24 additional antigens and concluded: "No significant immunophenotypic abnormalities detected." Happy with this obviously. This would seem to indicate that there is no evidence of other leukemic abnormalities such as AML, etc., correct?

In the Hematopathology section of the report they noted "no significant leukocytosis, over granulocytic left-shift, or other significant morphologic abnormalities. They did note "molecular residual evidence of CML" (which is expected) and my PCR is at 0.8 % after just over a year of treatment. 

Here's my question: In the Peripheral Blood section under Leukocytes then noted that "evaluation is limited by degenerative changes includes many pyknotic cells. Granulocytes are normal ... no significant monocytosis, eosinophilia, or basophilia are seen." Is a higher than normal number of pyknotic leukocytes (neutrophils) cells normal with CML treatment? Given the lack of antigens would this indicate cells that are in the process of dying off (apoptosis)?

I also had an elevated MONO% of 14 (range 4-12) although MONO# was high end of normal at 0.9 (reference range 0.1 - 0.9).

I've since had another blood draw and have a follow up appointment next week. Just curious if anyone might have suggestions on questions I might ask my oncologist?

Thank you!

[Trey]

My reading of it is the sample was degrading rapidly due to improper storage or sample age.  The white blood cell nucleus shrinks (pynknosis) as the cell is dying.  This starts fairly quickly in a blood sample unless it is kept cool. 

The MONO and all non-neutrophil white blood count percentages are not very useful since there are often fewer neutrophils during TKI CML treatment.  When the neutrophil numbers are low, the rest of the white blood cell percentages will be higher (even if normal levels) since the total must always be 100%.  White blood cell absolute numbers are more useful.

Flow cytometry is not as useful for CML treatment unless the disease gets out of control.

[August1]

Hi,

I just wanted to follow up on my original post. The "elevated" monocytes looks to have been only a temporary thing. My latest CBC from today has them down to about .7 (reference range .1 - .9). These counts seem to jump around a little which seems to be normal physiological response.