Re: Re: Lymphocytes Atypical & Blast- Dr. Furman

[Guest guest]

Dr.Furman,

Now, I am terrified. My “atypical lymphoctyes”

are 18 and regular lymphs 2, so that is 90%!!!! My WBC is 24, up from 21

two years ago.

I do see a CLL specialist in NYC, who is known, who never

mentioned that I have prolymphocytic leukemia, which I understand has a worse

prognosis.

Did my CLL specialist miss this after so many appts?

Elmer

From:

[mailto: ] On Behalf Of rrfman

Sent: Wednesday, January 06, 2010 7:08 PM

Subject: Re: Lymphocytes Atypical & Blast

Atypical lymphocytes are lymphocytes that look

different than the typical CLL lymphocytes. Under normal conditions, they tend

to indicate activated lymphocytes, like what would be seen in a viral

infection.

In CLL, seeing atypical lymphocytes is expected. In fact, one is allowed to

have up to 55% of their lymphocytes be atypical lymphocytes and still be called

CLL. Higher than 55% and they need to be termed prolymphocytic leukemia.

The blasts are likely just atypical lymphocytes that were miscalled. They tend

to appear very similar.

Rick Furman, MD

>

> Hi,

>

> I have been a member of this group for a while, but haven't been posting

much.

>

> I have a question regarding the blood test i did today. My report says

that there are 'Atypical Lymphocytes & Blast 2%'. Is that something to be

worried about?

>

> I have been treated on and off with Chlorambucil and all my counts are

normal (except 73% Lymphocytes and WBC 30,000). This is the first time i am

seeing this in my blood report.

>

> When i read up i foung atypical could relate to an infection response, but

find worrying things about blast, like early stages of ALL.

>

> Do anyone have any experience in dealing with this?

>

> Regards,

> Pradeep

>

[Guest guest]

Dr. Furman,

Thanks for such a speedy reply. I was frantically

calculating percentages of atypical lymphs since diagnosis. I had asked

our CLL specialist about a year ago, and he said “not to worry about them”.

So, I put it on the back burner until I read the previous

answer. I am asymptomatic, cd38- and perhaps zap70+, depending on if the

lab was any good. As I said, wbc 21 -24 and ALC 13-18 in last two years.

I appear to have had CLL two years prior to that, but not picked up as ALC and

WBC were only slight above normal ranges. I do not have an enlarged

spleen, which I read was a common PLL symptom. Given the above, should I

just do as my doctor has advised, and have my bi-yearly check-ups?

Thanks again very much for answering my so quickly and saving me

more than a few minutes angst.

Elmer

[Guest guest]

Dr.

Furman,

Thank

you. Your response is much appreciated.

Elmer

[Guest guest]

doctor ,thanks for the clarity sir, futher would like to know, that as you have said that plats and hemoglobin should be stable ,

is the downward slide of one piont ,over 9 months in hemoglobin and variation of plats in a 2.0 to 2.4 range is considered as stable ..

there is no enlargement of liver,spleen etc and no lympadenopathy etc

i am cd-38= 19% and zap-70=41%, fish panel=negative and diagnosed in 04/09

From: rrfman <rrfurman@...>Subject: Re: Lymphocytes Atypical & Blast- Dr. Furman Date: Thursday, January 7, 2010, 9:25 AM

What is really the most important for people to remember is that prognostic markers only tell you which curve you are on, they do not tell you where you are on the curve. Nothing is more helpful than the pace of your disease. If you WBC is rising slowly, Hemoglobin and platelets stable, lymphadenopathy and spleen size stable, then you are behaving in a very indolent manner. This means that the CLL is progressing very slowly and, by and large, will continue to do so for future.Rick Furman, MD>> Dr. Furman,> > > > Thanks for such a speedy reply. I was frantically calculating percentages> of atypical lymphs since diagnosis. I had asked our CLL specialist about

a> year ago, and he said "not to worry about them".> > So, I put it on the back burner until I read the previous answer. I am> asymptomatic, cd38- and perhaps zap70+, depending on if the lab was any> good. As I said, wbc 21 -24 and ALC 13-18 in last two years. I appear to> have had CLL two years prior to that, but not picked up as ALC and WBC were> only slight above normal ranges. I do not have an enlarged spleen, which I> read was a common PLL symptom. Given the above, should I just do as my> doctor has advised, and have my bi-yearly check-ups?> > > > Thanks again very much for answering my so quickly and saving me more than a> few minutes angst.> > > > Elmer>

[Guest guest]

doctor, thanks for the reply

and clarification,after how many months should i go for my next visit to heomotologist for check up etcsanesh

From: rrfman <rrfurman@...>Subject: Re: Lymphocytes Atypical & Blast- Dr. Furman Date: Thursday, January 7, 2010, 6:32 PM

The numbers look different than what most of you will be use to seeing, but these numbers are stable. > >> > Dr. Furman,> > > > > > > > Thanks for such a speedy reply. I was frantically calculating percentages> > of atypical lymphs since diagnosis. I had asked our CLL specialist about a> > year ago, and he said "not to worry about them".> > > > So, I put it on the back burner until I read the previous answer. I am> > asymptomatic, cd38- and perhaps zap70+, depending on if the lab was any> > good. As I said, wbc 21 -24 and ALC 13-18 in last two years. I appear to> > have had CLL two years prior to that, but not picked up as ALC and WBC were> > only slight above normal ranges. I do not have an enlarged spleen, which I> > read was a common PLL symptom. Given the above, should I just do as my> > doctor has advised, and have my bi-yearly check-ups?> > > >

> > > > Thanks again very much for answering my so quickly and saving me more than a> > few minutes angst.> > > > > > > > Elmer> >>