5 replies to this topic

[snowbear]

Here are my CBC results that my Hema/Onc did.  They were one week apart.  Are the myelocytes, metamyelocytes, and promyelocytes the same as "blasts" ?   I have a BMB scheduled for this Friday, but am very symptomatic and curious if anything should be done before then.   Thanks!!

 

WBC 3.8-10.6 X10E+09/L 36.1 H

RBC 3.73-4.89 X10E+12/L 4.64  

Hgb 11.6-14.6 g/dL 13.3  

Hematocrit(HCT) 34.1-43.3 % 40.1  

MCV 82.6-97.4 fL 86.4  

MCH 27.8-33.4 pg 28.7  

MCHC 32.7-35.5 g/dL 33.3  

RDW 11.8-15.2 % 14.2  

Platelets 156-369 X10E+09/L 346  

Mean Platelet Volume 6.8-10.4 fL 7.5  

Neutrophils 44.3-77.1 % 63.0  

Lymphocytes 13.0-43.8 % 10.0 L

Monocytes 3.7-12.5 % 3.0 L

Eosinophils 0.2-6.0 % 1.0  

Basophils 0.1-1.2 % 0.0 L

ABS Neutrophils 2.24-7.68 X10E+09/L 24.2 H

ABS Lymphocytes 0.80-3.65 X10E+09/L 3.6  

ABS Monocytes 0.3-0.9 X10E+09/L 1.1 H

ABS Eosinophils 0.0-0.4 X10E+09/L 0.4  

ABS Basophils 0.0-0.06 X10E+09/L 0.0  

TYPE OF DIFFERENTIAL   Manual Diff Performed  

RBC Morphology   Includes:   Normal RBC Morphology

Platelet Morphology   Includes:   Normal Platelet Morphology

Bands 2-8 % 4.0  

Metamyelocytes 0 % 12.0 H

Myelocytes 0 % 6.0 H

Promyelocytes 0 % 1.0 H

ABS Metamyelocytes 0 X10E+09/L 4.3 H

ABS Myelocytes 0 X10E+09/L 2.2 H

ABS Promyelocytes 0 X10E+09/L 0.4 H

WBC Morphology   Includes:   Normal WBC Morphology

 

 

 

 

 

 

WBC 3.8-10.6 X10E+09/L 41.7 H

RBC 3.73-4.89 X10E+12/L 4.58  

Hgb 11.6-14.6 g/dL 13.2  

Hematocrit(HCT) 34.1-43.3 % 39.7

  MCV 82.6-97.4 fL 86.7   MCH 27.8-33.4 pg 28.7

  MCHC 32.7-35.5 g/dL 33.1   RDW 11.8-15.2 % 14.7

  Platelets 156-369 X10E+09/L 380 H

Mean Platelet Volume 6.8-10.4 fL 7.7

  Neutrophils 44.3-77.1 % 63.6  

Lymphocytes 13.0-43.8 % 7.5 L

Monocytes 3.7-12.5 % 3.7  

Eosinophils 0.2-6.0 % 1.9  

Basophils 0.1-1.2 % 1.9 H A

BS Neutrophils 2.24-7.68 X10E+09/L 29.2 H

ABS Lymphocytes 0.80-3.65 X10E+09/L 3.1  

ABS Monocytes 0.3-0.9 X10E+09/L 1.5 H

ABS Eosinophils 0.0-0.4 X10E+09/L 0.8 H

ABS Basophils 0.0-0.06 X10E+09/L 0.8 H

Bands 2-8 % 6.5  

Metamyelocytes 0 % 4.7 H

Myelocytes 0 % 9.3 H

Promyelocytes 0 % 0.9 H

ABS Metamyelocytes 0 X10E+09/L 2.0 H

ABS Myelocytes 0 X10E+09/L 3.9 H

ABS Promyelocytes 0 X10E+09/L 0.4 H

Polychromasia   1+

  OVALOCYTES   1+

[Lucas]

Hi. They are early cells but not blast. The blast are myeloblast and lymphoblasts. These last two defines blast count to fins in what phase you are. Good luck

[Trey]

Although you have previously described your CML as possibly advanced, I do not see that in the CBC report.  Granted, it is not conclusive.  But if the doc told you that your blast count was high based on the myelocytes, metamyelocytes, and promyelocytes, these should not be added into a typical "blast count" since they are more mature than the myeloblast (blast), even though they should not typically be in the blood.  They are supposed to stay in the marrow until mature, but when the marrow is "full" as with CML they can sometimes get kicked out early.  I don't see the actual myeloblast (blast) count on your list. 

http://en.wikipedia....an)_diagram.png

 

Your WBC is relatively low for a CML diagnosis, and your platelets are barely high.  These do not suggest a long duration disease.  Your Absolute Neutrophil Count is the most conclusive part of the report, which usually indicates leukemia.

 

There is little doubt you have CML, but I would not worry so much about the Phase given this information you supplied here.  I would just wait for the BMB and see what it shows. 

[snowbear]

Thanks so much for clarifying the difference between blasts and just immature cells.  Out of curiousity, how does the ABS Neutrophil count indicate leukemia?  

 

I've had a high neutrophil to low lymphocyte ratio for several years now and docs always said it was from inflammation, which now they are saying may be my immune system trying to fight the leukemia.

[Trey]

The percentages are misleading, so always use the absolute numbers.  Look at your ABS NEUT number and it is about 4 times normal (CML is mainly leukemic neutrophils), but your NEUT % is normal.  So the percentages do not tell the story in many cases since they must always add up to 100%. 

 

Regarding chronic inflammation, neutrophils are the primary cell involved in short term inflammatory response, but for long term chronic inflammation as you have described the monocytes become the primary cell involved. 

 

Your docs saying your immune system may be "trying to fight the leukemia" is not accurate.  In CML the neutrophils ARE the leukemia.  They are not fighting themselves.

[snowbear]

Honestly, Trey, I may not be explaining myself very well.  Over the course of 3 appointments, the Hema/Onc doctor has explained so much stuff that I may not be getting it all straight in my head. But, I know the docs want to wait to see how I respond to Gleevec before changing or adding any more meds for the rheumatic stuff.   

 

I'm just anxious to get this show on the road.  Tired of feeling like hell although from the sounds of things, it will be awhile before I feel any better.