What Does The Following Blood Test Result Indicate?

Posted on Fri, 2 Dec 2016

Question: Doctor my brother (26 years old) diagnosed with CML. Docs confirmed with FISH test 99 % CML. Intially (July 2016) his wbc count were only 75,000. Doc prescribed to take imatinib oral drug. Monthly once taken blood test. After taking medicine and proper diet his wbc count drastically reduced to 4000 by September. Same drugs, proper diet were continued since then upto now. though he has taken medicines he always have leg and hand pain. But today his wbc count is 4,45000 and there is swelling and severe knees and hand. What to do doctor ? Is my brother has only few days left to survive? what it indicates? He is in which stage? Anyother ways to bring down the wbc count? Kindly suggest.

Answered by Dr. Deepak Sundriyal (1 hour later)

Brief Answer:
I will advise to repeat the blood counts

Detailed Answer:
Hello dear.
I have gone through the details.

However i still doubt the reports because cml responds very well to imatinib and it is very unlikely that imatinib fails so early. Usually it works well for years. So please repeat the blood counts and share the details, so that I can better answer your questions. If counts are elevated then it may be a case of accelerated stage or blast crisis stage. Even in these stages treatment is possible.

Thanks and regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Sundriyal (3 hours later)

Doctor thrice checked the CBC. Please have a look.
RBC - 2.10
WBC - 445840
Hemoglobin - 8.4
MPV - 8
MCV- 94
MCHC - 31
MCH-29
RDW- 20
PCV- 28
Lymphocyte - 93
Monocyte - 04
Eosinophil - 00
Neutrophil - 03
ESR - 70 (60 min)
Platelet - 69000

Two days before along with imatininb he took some vitamin supplements , Renerve24 mg - 2 tabs, Vitamin D3 (D-bright) - 1 tab, Vitamin -E (Evion) - 2 tabs, Cyra/D - 4 tabs. He has intermittent fever, swelling, cramps, fatigue

Do we have to consult the doc immediately? Because we got appointment after 4 days only. What are all the possible treatments in this stage and best hospital for this? Is it completely curable? How long he will survive? Can he lead a normal life?

Answered by Dr. Deepak Sundriyal (9 hours later)

Brief Answer:
Hello dear. You should visit a doc soon

Detailed Answer:
Hello dear. If the blood counts have been checked, then it is an advanced stage. A bone marrow examination is must at this stage. Treatment is possible ar this stage but the success rate will be low. Actual survival nobody can predict but still he has many more years to live. If it is a blast stage, then treatment will include chemotherapy, and if it is accelerated stage then only change of drug is sufficient
Thanks and regards

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Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar