help in figuring out stage of CLL

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Hello all,

Its Sheela again. So we had two different tests done in two different

labs. One on Jan 8th and one on Jan 11th. The results are below. We

are trying to figure what stage her CLL is , and she can be treated.

Based on your experience if any of you can give an indication of

stage it will be much appreciated as we are very worried and the

various tests are taking forever to schedule and get results. The

test values are below. Thanks a ton.

Whole abdomen scan done 3 Jan. 08. Impressions:

CAUDATE LOBE OF LIVER APPEARED ENLARGED.

BOTH PORTAL VEIN AND SPLENIC VEIN APPEARED ENLARGED.

SUGGESTIVE OF EXTRAHEPATIC PORTAL HYPERTENSION.

MASSIVE SPLENOMEGALY.

NORMAL APPEARING GALL BLADDER, COMMON DUCT, PANCREAS, BOTH

KIDNEYS, BLADDER, UTERUS, ENDOMETRIAL CAVITY.

NORMAL DOPPLER STUDY OF AORTA AND BOTH RENAL ARTERIES.

NO EVIDENCE OF RENAL ARTERY STENOSIS.

HEMATOLOGY TEST(8 Jan 08 Observed value Reference Range

Total WBC Count 20,100 4000 - 10,000/cmm

Polymorphs 15 40 - 80%

Lymphocytes 83 20 - 40%

Eosinophils . 1 - 6%

Monocytes 2 2 - 10%

Basophils . 0 - 2%

E S R - 1 hr 16 < 20mm

Haemoglobin 11.2 12 - 15 gm%

Hematocrit 35.0 36 - 46%

R B C Count 4.68 3.8 -4.8 mill/cmm

MCV 74 83 - 101 fl

MCH 24.0 27 - 32 pg

MCHC 32.0 31.5 - 34.5%

RDW 17.7 11.6 - 14.0%

Platelet Count 152 50 - 400 thou/

cmm

All done by Automated Counter & only ESR by Westgren/Automated.

REPORT:

Peripheral Smear Study (Microsc opic):

RBCs: Microcytic and hypochromic in appearance with

anisopoikilocytosis.

Parasites: No malarial parasites or haemoparasites are seen.

WBCs: Leucocytosis is seen with increase in lymphocytes.

Immature cells: No immature cells or atypical cells are seen.

Platelets: Adequate in number with normal morphological

appearance.

Here is the other test

HEMATOLOGY TESTS (contd.) (8 Jan. 08)

Observed value Reference Range

Biochemistry:

Glucose - Fasting 98 74 - 106 mg/dl

Blood Urea Nitrogen 12.4 7-18 mg/dl

Creatinine 0.8 0.6-1.1 mg/dl

Bilirubin - Total 0.4 0.2-1.0 mg/dl

Enzymes:

SGOT(AST) 27 < 40 U/L

SGPT(ALT) 21 < 41 U/L

Alkaline Phosphatase 77 36 - 141 U/L

Gamma GT 24 < 38 U/L

Proteins:

Total Protein 6.7 6.6-8.8

gm/dl

Albumin 4.4 3.3-4.5

gm/dl

Globulin 2.3 2.3-3.5

gm/dl

A/G Ratio 1.90

Eletrophoresis is the

preferred method

Protein Electrophoresis:

Total Protein 6.7 6.6-8.8gm/dl

Albumin 57.5 52 - 65%

Alpha 1 Globulin 3.3 2.5 - 5.0%

Alpha 2 Globulin 14.1 7-13%

Beta Globulin 12.2 8-14%

Gamma Globulin 12.9 12-22%

Albumin/Globulin Ratio 1.35

Hepatitis Markers:

HBsAg NEGATIVE

Report:

Anti HBc-Total NEGATIVE

Anti-HCV NEGATIVE

HAEMATOLOGY (some aspects) test done 11 Jan.08 in another lab.

Test result REF.

range

ESR i hr. (Westgren) 11 mm/ 1 hr Women 0 - 20

WBC Count(TC)(Automated - 24,140 cu.mm 4,000 - 10,000

Counter)

PERIPHERAL SMEAR STUDY:

Result: RBC: Normocytic, hypochromic seen.

WBC: Neutrophils: 17% 40 - 75

Lymphocytes: 80% 20 - 50

Prolymphocytes 03% 20 - 50

Smudge cells (+)

Platelets are adequate and the number is in the normal

range.

Impression:

C L L (Chronic Lymphocytic Leukemia)

Thanks You guys