16 replies to this topic

[JohnFromChicago]

My absolute eosinophils counts are normally around 0.3 [roughly 4%] and never 0.0. I do have seasonal allergies and the past few days I have been having quite the runny nose. Although Today I felt great (no allergy symptoms). Today at my checkup my eosinophils were at 0.7. My oncologist said she was going to send my blood for further analysis due to this high count. This of course sent my anxiety though the roof. I actually was having some anxiety two few weeks back and came in for an "ad-hoc" CBC as this generally helps me to deal with it. At this time thirteen days ago my eosinophils were normal at .0.2 [3.9%]. I looked back at my results over the last 24 months (my DX was 2 years ago) and I see that my absolute eosinophils had been at 0.7 on one other occasion almost exactly a year ago. She actually didn't say anything about this a year ago when I had the identical result. This gives me some comfort this is caused by seasonal allergies but I am still pretty freaked out. If anyone has experience with similar numbers it would be great to hear. Of course now I have to wait a week with anxiety till my PCR comes back from todays appointment. 

 

Absolute Neutrophils: 4.2 [56.1%]

Absolute Basophils: 0.0 [0.4%]

Absolute Eosinophils: 0.7 [9.8%]

Absolute Lymphocytes: 1.9 [25.8%]

Absolute Monocytes: 0.6 [7.9%]

WBC: 7.5

SEG: 58%

[lanadal]

Hi John, I have had CML for 14 years and my Eosinophil count has bumped up and down from .30 to 8.40 for years. Dr. Mauro, a CML specialist at OHSU, said that these numbers were very common with CML and can reflect allergies, but he was not concerned. I do have mild seasonal allergies. Maybe someone else can supply the background information, but for now I hope this will help calm your worrying. Best, Lynn

[JohnFromChicago]

Hi John, I have had CML for 14 years and my Eosinophil count has bumped up and down from .30 to 8.40 for years. Dr. Mauro, a CML specialist at OHSU, said that these numbers were very common with CML and can reflect allergies, but he was not concerned. I do have mild seasonal allergies. Maybe someone else can supply the background information, but for now I hope this will help calm your worrying. Best, Lynn

 

Thanks so much for your response Lynn! Do you know if your results (.30 to 8.40) if that is the % or if it is the absolute. I have added my % values above for comparison. Im guessing yours are most likely a % so at 9.8% mine is slightly higher than your highest.

[Trey]

Allergies.  Your other counts would be off if it were an issue.  Most people don't realize how much their blood counts jump around since they never have blood tests. 

[tiredblood]

Mine have ranged from 0-4%, mostly 2%, with 4%, the highest right after my CML diagnosis. I did take allergy shots somewhere in there, so that probably affected my EOS.

[JohnFromChicago]

Allergies.  Your other counts would be off if it were an issue.  Most people don't realize how much their blood counts jump around since they never have blood tests. 

 

Thanks for the response Trey. I just could not seem to find anyone who had this high of an eosinophil count at 0.7 [9.8%] this far into treatment (24 months) so it was really starting to freak me out as I understand a rise in eosinophil can be the first indicator of disease progression. 

[JohnFromChicago]

Mine have ranged from 0-4%, mostly 2%, with 4%, the highest right after my CML diagnosis. I did take allergy shots somewhere in there, so that probably affected my EOS.

 

Seems your highest is my roughly my average since normally my eosinophils are about 0.3 [roughly 4%]. Although my oncologist never has seem concerned by any of my previous eosinophil values even the one other test a year ago about 12 months after my diagnosis when I was at 0.7 [7.2%] which is the same absolute count which sparked her attention Today. Hopefully this is all just a result of my seasonal allergies though.

[chriskuo]

Over 7 years, my eosonophils have fluctuated as high as 1.0  and sometimes remain elevated for 2 or 3 tests in a row.  I have never had an onc question them.  You should check your doctor's background - may be relatively inexperienced with CML.  If you have no other issues with her, it may not be worth changing yet.  Hopefully, you will never have serious issues or side effects, but you should be prepared to switch to a more experienced CML specialist.  Jumping to special testing for what is barely out of range seems like a gross overreaction.

[JohnFromChicago]

Over 7 years, my eosonophils have fluctuated as high as 1.0  and sometimes remain elevated for 2 or 3 tests in a row.  I have never had an onc question them.  You should check your doctor's background - may be relatively inexperienced with CML.  If you have no other issues with her, it may not be worth changing yet.  Hopefully, you will never have serious issues or side effects, but you should be prepared to switch to a more experienced CML specialist.  Jumping to special testing for what is barely out of range seems like a gross overreaction.

 

Thanks so much for your reply! It is really nice to see someone who has had similar eosinophil results and is doing so well!! I know my oncologist only does hematology oncology. She is at a major university hospital here in Chicago, Northwestern. However, I have no clue how many other CML patients she has treated. She has already told me though that she does not believe in dose reduction only cessation when I inquired a few months back. This was a red flag for me. Although I am not quite at the point where I personally would feel comfortable with dose reduction. One year from now if my numbers continue their trend I definitely want to reduce my dose to 70mg or even 50mg of Sprycel so I will need to most likely switch oncologists at that point. It is a shame because the hospital is less than a mile from both my home and office which makes it very convenient and I have find both her and the hospital itself to be very timely, caring and well organized.

[TeddyB]

I too had some worries with higher levels, but it turned out to be nothing to worry about

 

http://community.lls.../?hl=eosinophil

[lanadal]

John, My results were a percent. I think it is important to have a CML specialist if at all possible.

Per your doc talking about cessation rather than dose reduction...I was surprised and interested to hear Dr. Mauro on the webinar "What's on  the Horizon for Chronic Myeloid Leukemia" say there was some thinking a reduction might allow mutations where a cessation wouldn't?!? I haven't found anything else on that topic. I am currently reducing my dose, so I am very interested. Unfortunately in order to afford my meds I had to switch to Kaiser and my current doc isn't particularly helpful.

[Buzzm1]

John, My results were a percent. I think it is important to have a CML specialist if at all possible.

Per your doc talking about cessation rather than dose reduction...I was surprised and interested to hear Dr. Mauro on the webinar "What's on  the Horizon for Chronic Myeloid Leukemia" say there was some thinking a reduction might allow mutations where a cessation wouldn't?!? I haven't found anything else on that topic. I am currently reducing my dose, so I am very interested. Unfortunately in order to afford my meds I had to switch to Kaiser and my current doc isn't particularly helpful.

Landal, there isn't any published evidence that dose reduction, or cessation, contributes to mutations, or resistance.   I am also a Kaiser member and although I am currently TFR, I am pleased that they have continued to designate generic Imatinib a Tier 2 drug, available at a small monthly copay.  How long have you been on 300mg?  Other than the possibility of experiencing withdrawal side-effects, there isn't any reason for you not to continue to reduce your dosage.  

[Trey]

The cell count percentages should not be used until the CML has been long under control.  At first the neutrophil percentage will be way high, and distort all the other percentages.  Then the neutrophil percentages tend to go too low during the early stages of tki treatment since it is eliminating/suppressing mostly the neutrophils, and the other cell percentages will be distorted into looking too high.  This is because the percentages must always add up to 100%, so if one is high or low, the others will make up for it and be distorted.   

[kat73]

lanadol - Where in that webinair did Dr. Mauro say that, and how did he say it?  Is there a way to get the transcript from the webinair, I wonder?  I am appalled that there is not consensus on this MOST important question of dose reduction and the danger of drug resistance!!!!!  My CML specialist said the same thing: "I'd rather you try cessation than to take 20 mg Sprycel; that can cause resistance.  How do you think we create resistance in the lab in order to study it?"  That's a direct quote from my onc.  What does Dr. Mauro say?  Dr. Cortes doesn't seem to believe it - here's Scuba, undetected, and he was on 20 mg from the very beginning.  I'm at my wit's end on this question.  Sorry if I've hijacked.

[lanadal]

I have been on 300 mgs Imatinib (generic-Teva) for 9 months and in 3 months, if all continues to go well, I will go to 200 mgs.

 

Mauro mentions his statement about cessation rather than low dosage toward the end of the Webinar.  The link is still at the top of this page. I can't find a written transcript yet, but it says the transcript will be available soon on the LLS site

 

http://www.lls.org/p...yeloid-leukemia 

 

 

I haven't found anything else on this topic either. 

[JohnFromChicago]

The additional analysis came back seems pretty normal to me does not really contain much new information. I'm feeling pretty confident now though that the 0.7 [9.8%] eosinophils was most certainly my allergies and nothing CML related.

 

 

 

 

Normocytic normochromic red blood cells with unremarkable morphology.

 

Neutrophils are adequate with unremarkable morphology. 

 

Mild absolute eosinophilia (0.7 k/uL) with mature-appearing eosinophils.

 

Platelets are adequate in number and show occasional large forms. 

 

Comment:  The clinical significance of the mild absolute eosinophilia is unclear from review of the peripheral blood smear.  Correlation with the pending molecular studies (MG17-2217) is recommended to evaluate the disease status of the previously diagnosed CML.

[JohnFromChicago]

Just received my results form last week .047 not much of a drop from .051 but I am happy with it