Patient's Query
Hello doctor,
I went to the hospital for my father's regular check-up. He is 61 years old. His report looks like this: WBC 43000, platelets 120,000 per microliter of blood, and lymphocytes 88 percent.
To get it cross-checked, we went to another laboratory the next day, and here are the counts: WBC: 38000 (reduced by 5000), platelets 1,50,000 per microliter of blood (increased by 30000), and lymphocytes 84 percent (decreased by four percent). I am assuming that this is a good sign, as the WBC count has gone down by 5000 in one single day, and the platelet count has gone up by 30000.
The doctor has recommended chronic lymphocytic leukemia, which is kind of scary. This will take three days to come. My father is physically active and has no medical conditions. He works out as well and walks a lot. I have seen him going up and down the stairs (fifth floor) twice or thrice a day, and he does not feel any weakness.
No smoking or drinking habits. He is a pure vegetarian. No fever or pain. We went for a regular check-up just like that, and that is when this report came up. No history of any such disease in his family tree. Other reports are fine. Doctors did not find any alarming symptoms.
He had gone through angioplasty eight years ago, and since then, he has been visiting his cardiologist every six months but never gotten his blood checked.
Can you please help?
Thank you.
Hello,
Welcome to icliniq.com.
Your father has absolute lymphocytosis. Repeat CBC (complete blood count) after one week, along with a complete peripheral smear examination to look for abnormal malignant cells like blasts.
If the count does not come down, then investigate with a flow cytometry examination to rule out lymphoma or monoclonal B cell lymphocytosis.
I hope your concern is solved.
Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
I can see that the hospital took a second sample, and the peripheral smear section was mentioned as follows. RBC: normocytic normochromic with few macrocytes. WBC: marked leukocytosis with lymphoid cell prominence. These lymphoid cells have mature lymphocyte morphology. Smudge cells are seen in the background. Platelets: mild thrombocytopenia. Suggestive of lymphoproliferative neoplasm.
Suggest immunophenotyping and cytogenetics. Currently, as per the doctors' unofficial remarks, they are doing the diagnosis for CLL, and there are strong chances of lymphoma. The CLL test results are going to come in a few days.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
I can understand your fear regarding cancer-like conditions.
But in the peripheral smear, smudge cells are seen, and lymphocytosis is present. So we cannot take a risk, and we have to wait for the report. I hope that the report will come back to normal.
If CLL is confirmed, then the doctor will do a physical examination and necessary tests to judge the prognosis.
Your father's clinical condition is good, and if anemia, hepatosplenomegaly, lymphadenopathy, or low platelet count are not present, then the prognosis is very favorable.
But, just now, the main focus is to diagnose CLL by flow cytometry or other suitable higher-level investigations.
I hope your concern is solved.
Take care.
Patient's Query
Hi doctor,
Thank you for your reply.
We have got the analysis done.
Thank you.
Hello,
Welcome back to icliniq.com.
Kindly attach the report to comment on that.
I hope this helps.
Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
He is diagnosed with CLL Stage A. I am trying to attach the result of cytometry and the doctor's report post-analysis. He says it is in the initial stage, and no treatment is needed.
Every three months, he has to visit the hospital for a WBC count check. Please let me know:
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
In the stage 1 phase, only lymphocytosis with enlarged lymph nodes is the presentation. Prognosis is intermediate in this case, and median survival is around seven to eight years.
So it is good that cancer is not at an advanced stage. Close clinical follow-up is done in such cases. If the tumor load is high, then chemotherapy will be given.
I hope this helps.
Please revert in case of further queries.
Thank you.
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Answered byDr. Goswami Parth Rajendragiri
Medically reviewed byiCliniq medical review team
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