WBC in CLL stable, but not the Lymphocytes and Platelets.

[kd1625]

I am 60 and was diagnosed with CLL last year.  I've gone in four times for follow-up labs and am now on a yearly watch.  It's running an indolent course, but I'm a little confused by some of the labs.  My WBC has remained stable between 12-15, but each lab results shows a pattern of the Lymphocytes increasing from the each previous lab.  ALC was at 5, but now is 9.  The platelets have been trending down with each lab as well, but still in normal range.  Was at 256, but now is 188.  Neutrophils are at 15%.  Is this a normal pattern with CLL where the WBC are stable, but the Lymphocytes and Neutrophils are not, along with the platelets?  I had a recent neck MRI which showed the bone marrow as somewhat heterogenous, which I was told was related to the CLL.  I only have a small pea size lymph node in my neck, but other than bruising easily and fatigue (for which I take Modafinil due to fighting sleep all day), I'm in good shape.

[Ken_PA]

Hi, if Lymphocytes go up while Neutrophils go down, that can balance out and make the WBC mostly unchanged.  WBC is the sum of all white blood cells.

As Lymphocytes go up, the *percentage* of Neutrophils goes down --  just as a matter of the math. As long as your *Absolute* Neutrophil Count is high enough to keep you from getting constant infections, that's not a problem. You would be worried by fevers, e.g.

Platelets at 188 shouldn't be low enough to be giving you easy bruising. Maybe that needs investigation. Your liver isn't swollen or tender, right? Spleen?


As far as I know, treatment is given only when you have significant symptoms. Your WBC can get far, far higher than what you have and that's still not good enough reason to begin any treatment.

That's my guesswork. Good luck to you, I hope you keep doing okay.

[kd1625]

Thank you. I'm sure this will continue to be stable for years.