Fwd: Re: question on rate of rise at low numbers? Re:WBC

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Another post from our own Dr. Furman about the significance of a rising WBC.**************Looking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos. (http://autos.aol.com/cars-BMW-128-2008/expert-review?ncid=aolaut00050000000017 )

Helene,

I think you are making perfect sense. Now lets see if I answer your

question.

Some patients start with low WBC and:

1. Rise gradually

2. Rise rapidly to a plateau and then slow down.

3. Rise slowly and then accelerate.

4. Rise rapidly.

As you can see, anything is possible. Biologic systems are all

variable. Rising WBC are indicative, some of the time, of someone

who will need treatment in the not to distant future. The rising WBC

is not, in and of itself, an automatic reason for treatment. Needing

treatment will depend a great deal on anemia, thrombocytopenia, size

of lymphadenopathy and splenomegaly. Sometimes I will treat someone

with just a rising WBC because of concerns about the WBC getting so

high that it would be risky for tumor lysis when treatment is given.

This is would not be until the WBC would approach 150,000 or higher.

Rick Furman, MD

>

> I am searching high and low for an answer to this, and postings on

> other forums have netted no responses, which makes me think I am

not

> asking clearly. So, here is my best shot:

>

> Have people experienced a more rapid increase in ALC at the

> beginning, or has everyone started out slowly and either a)stayed

> there or b)climbed later?

>

> I see lots of people never have high ALCs and that move very slowly

> for a few years. Has anyone had them move quickly until they got

to

> a plateau?

>

> I am very, very nervous about trying to make sense of counts that

go

> from 5 to 7, then jump to 14, then again to 20, each within a

shorter

> period.

>

> Is this definitely a sign of worsening, and rapid progress to

> treatment? Or could it slow down? Our doctor has been elusive

about

> this.

>

> Thanks to anyone who has any light to shed on this for me.

>

> Helene

>