Q. We went for a regular check up and reports suggest leukemia. Can you help?

Answered by Dr. Parth R Goswami and medically reviewed by iCliniq medical review team.

 

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Hello doctor,

I went to the hospital for my father's normal check-up. He is 61 years old. His report looks like this: WBC 43000, platelets 1.2 L, and lymphocytes 88 %. To get it cross-checked, we went to another lab the next day and here are the counts: WBC: 38000 (Reduced by 5000), platelets 1.5 L (increased by 30000) and lymphocytes 84 % (decreased by 4 %). I am assuming that this is a good sign where WBC count has gone down by 5000 in one single day and 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 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 is visiting his cardiologist every six months but never got his blood checked. Can you please help?


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Dr. Parth R Goswami
M.B.B.S., M.D
Hematology, Pathology

Hello,

Welcome to icliniq.com.

Your father has absolute lymphocytosis. Repeat CBC (complete blood count) after one week along with complete peripheral smear examination to look for abnormal malignant cells like blasts.

If the count does not come down, then investigate with flow cytometry examination to rule out lymphoma or monoclonal B cell lymphocytosis.

Hope your concern is solved. Take care.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

 

Hello doctor,

Thanks a lot. I can see that the hospital took a second sample and peripheral smear section was mentioned as below. 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. Can you please explain it to someone from a non medical background on how serious is this? I am going through some articles on leukemia and lymphoma and they are something that has sent a shiver down my spine. I am hoping that there is some other infection that has caused this. What is the chance it is something like that?

 

Dr. Parth R Goswami
M.B.B.S., M.D
Hematology, Pathology

Hello,

Welcome back to icliniq.com.

I can understand your fear regarding cancer-like condition.

But in 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 normal.

If CLL is confirmed, then the doctor will do a physical examination and necessary reports to judge prognosis.

Your father's clinical condition is good and if anemia, hepatosplenomegaly, lymphadenopathy, or low platelet count are not present than prognosis is very much favorable.

But, just now the main focus is to diagnose CLL by flow cytometry or other suitable higher investigations.

Hope your concern solved. Take care.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

 

Hi doctor,

We have got the analysis done.

 

Dr. Parth R Goswami
M.B.B.S., M.D
Hematology, Pathology

Hello,

Welcome back to icliniq.com.

Kindly attach the report to comment on that. Hope everything is fine.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

 

Hello doctor,

He is diagnosed with CLL Stage A. I am trying to attach the result of cytometry and 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 WBC count check. Is there nothing that we can do? I have not told my father that he has cancer. It is incurable right? Can homeopathy help?

 

Dr. Parth R Goswami
M.B.B.S., M.D
Hematology, Pathology

Hello,

Welcome to icliniq.com.

In 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 case.

If tumor load is high then chemotherapy will be given.

Hope I have solved your query. Take care.

For more information consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist

 
 
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Does WBC count of 40000 suggest leukemia?
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Answer: Hi, Welcome to icliniq.com. Based on your query, my opinion is as follows: A count of 40000 is not high enough to think of leukemia on an immediate basis and leukemoid. The standard definition says count should be more than 50000 and should be caused by reactive causes outside the bone marrow. If y...  Read Full »
 
 

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