Help with reading my latest cbc

[roostermom]

This is my second time treating, I both times I have had weekly cbc' done and kept copies. On this report there was a bunch of stuff on the end of the report that I don't understand.

First I will give the out of range stuff - nothing too bad- and give the stuff I don't get:
WBC - 1.4
RBC- 3.04
Hemoglobin-10.0
Hematocrit - 30.2
RDW - 17.3
Platelet count - 108
Nuetrophils, absolute - 696
Lymphocytes, absolute- 553
Monocytes, absolute - 143
Eosinophils, absolute - 6

Ok not so bad, I have had much worse numbers than this, but here is all the stuff I don't get:

Slight Anisocytosis; Slight Polychromasia; Slight Elliptocytes; Slight Tear Drops; Slight Burr cells; Slight Toxic Granulation; Occasional large platelets seen.

I get that it has something to do with anemia and the shape of the red cells, but I don't get whether it is significant or noy

[roostermom]

Wow thanks for all of that! Apparently it sounds scarier than it actually is because the Dr told me not to worry about it. I am in week 17 and have been having weekly cbc's the entire time, so they are watching pretty closely.

How do you know all of this stuff?

[frijole]

THat is way too cool. I have never had a CBC with text information like you got.  A lot of it seems to be about the anemia, but some is about the absolute neutrophils.  I think you will need to watch them closely
frijole

Polychromasia (or Polychromatophilia) refers to having red blood cells of multiple colours, particularly gray-blue.[1] This is due to differing amounts of haemoglobin in each cell,[2] which is due to innapropriate, premature release from the bone marrow. This is commonly due to leukaemia, metastatic disease, pyruvate kinase deficiency and immune mediated haemolytic anaemia (IMHA

Anisocytosis is a medical term meaning that a patient's red blood cells are of unequal size. This is found in anemia and other blood conditions. False diagnostic flagging may be triggered by an elevated WBC count, agglutinated RBCs, RBC fragments, giant platelets or platelet clumps.

The red cell distribution width (RDW) is a measurement of anisocytosis[1] and is calculated as a coefficient of variation of the distribution of RBC volumes divided by the mean corpuscular volume

Elliptocytes, also known as ovalocytes are abnormally shaped red blood cells that appear oval or elongated.

These abnormal red blood cells are seen in blood films of patients with:

Hereditary elliptocytosis
Thalassemia
Iron deficiency
Myelophthisic anemias
Megaloblastic anemias
Retrieved from "http://en.wikipedia.org/w/index.php?title=Elliptocyte&oldid=390236376"

Burr cells are crenated red cells known as echinocytes seen on Wright Stain blood smear. RBCs with lost disc shape and spherical now covered with short, sharply pointed projections ... may be artefactual in older red cells..[adapted General Practice Notebook ONLINE 2009]

Toxic granulation is found in severe inflammatory states. The toxic granules are azurophilic, usually found in the promyelocyte, metamyelocyte, band, and segmented stages. The toxic granulation is thought to be due to impaired cytoplasmic maturation,in the effort to rapidly generate large numbers of granulocytes
this is the address of this one -- has some pictures.  THis is related to neutropenia
http://www.med-ed.virginia.edu/courses/path/innes/wcd/qualitative.cfm

[roostermom]

Good news from seeing the Dr yesterday. 2 weeks ago I was told I would have to do 9 Mo's vs the 6 Mo's , and yesterday he said my response was rapid enough that 24 weeks should be ok. He did say that if I was doing somersaults and feeling great, he good make me go a little longer. He also increased my ribo to 1000 from 800. I have had weekly cbc's since starting, and had to be on procrit for the last month of the Incevik.

[roostermom]

I was on neupogen the last time I treated, but this Dr won't put me on until the neutrophils drop below 500 - they have been as low as 547, but not below. I was on the procrit for the last month of Incevik when I got to 8.9, but near 10 they won't put you on as procrit at higher hemoglobin levels has a risk of causing blood clots.

[jt57]

When I was treating, if my Hgb got close to 9, I started procrit right away.  (I fought with anemia both treatments, even with procrit).  and the ANC my dr started neupogen when I got close to 500.  with your white count being 1.4, and your abs nuets being 696, you need to keep an eye on that as well.  Good luck.

Jean

[flcyclist]

Keep an eye on the Hemoglobin (Hgb) -10.0.  Have you discussed Procrit if it goes much lower?  The (ANC) Nuetrophils, absolute (696) looks ok for now, but keep an eye on that, too.  

[roostermom]

Thanks much

[pcds]

Don't worry about those weird numbers, mine are also and never a concern.   Your numbers look good