Retired :Certified Trainer in FIE

[Gerr930]

Diagnosed with Stage 4 Lymphoma and diff problem with cbc highs and lows
WBC 2.59

High  LYM 58.4 % although abs lym 1.51 is  normal;
           NE#.94,36.4 %, otherwise within average for all other wc,


RBC 3.68,     HGB 10.4, HCT 31.3 lows
RDW H 15.7,and  PLT 130 L

What course of chemo is appropriate ? Dr. is hesitant

[Ken_PA]

Gerr, besides the specific type and grade of lymphoma as Mocha says, a lot also depends depends on your age and physical condition, past treatments, the reason why some cell counts are abnormal, and other factors.

If most counts besides Lymphocytes are trending to the low end of normal, then that would make your Lymphocyte % high - but are the low ***** going low because of lymphoma in the marrow (reduced production) or did previous chemo kill them?

Mocha, I'd tend to disagree with you on necessarily going to a large center - unless there is some specific reason to do so. For most patients, they get the same diagnosis and treatments, because their local doc reads all the relevant literature. That's provided that the doc is a Hematologist or Oncologist experienced in lymphoma, of course.

There will be some variability in some circumstances, but that's even true between the large centers. For instance, someone going to Memorial S.K. in NYC might be treated differently that someone who goes to MD Anderson in TX, or even back to NYC at Weill Cornell.

The again, how would a patient know if their case was unusual i diagnosis or treatment, unless the get a 2nd opinion? Being self-educated about things and asking specific questions would be an answer - but for those who don't, then yes a 2nd opinion could be valuable.

Ah well, nothing is easy...

[Mochadelicious]

Hi Gerr930,
I'm sorry to hear about your lymphoma diagnosis.  What kind of lymphoma do you have?  Do you know yet what grade you are?  I'm not good with interpreting labs, but I will say it's always a good idea to get a second opinion about your diagnosis and treatment plan with another doctor, especially from a large research hospital (usually located in bigger cities).  Most likely the second doctor will run their own pathology tests to verifty the diagnosis and then make a recommendation for treatment (which may or may not be the same as the first doctor).  It's extremely important that an accurate diagnosis is made before they start treatment.