Ask the Lab Scientist Q3 2019

Questions submitted by readers and answered by the CLL Society Medical Advisory Board

By Susan Leclair, PhD, CLS (NCA)

What are the best markers in my blood tests to judge the progression of my CLL? At what level would a doctor generally start treatment?

Answer from Dr. Leclair: As all good physicians will tell you, there has never been a treatment decision based solely on laboratory test results. Treatment is determined by patient signs and symptoms, with assists or clarifications from the lab, x-ray, or other departments. 

For CLL, I would think that most physicians rely first on the CBC. Sudden or unusual spikes in white blood cell counts, significant drops in red blood cell numbers (RBC, hematocrit, hemoglobin), significant changes in the RBC indices or drops in platelet counts are all used in the determination of Rai’s staging. They would look at liver and spleen function tests as a reflection of lymphocyte issues in the nodes.

Imaging (CAT, PET, or MRI scans) would also be used to assess any changes in nodes that would not be felt during the physical exam.

But, to repeat, all of those would be chosen based on the patient’s complaints or presentation.

 

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Susan Leclair, PhD, CLS (NCA) is Chancellor Professor Emerita at the University of Massachusetts Dartmouth; Senior Scientist, at Forensic DNA Associates; and Moderator and Speaker, PatientPower.info – an electronic resource for patients and health care providers.