Re: question about watch and wait

[Guest guest]

Tracey - You don't say where you are or whether you are

dealing with an oncologist, hematologist, or CLL specialist.

I think I would want a second opinion, though from what I've

read lymph node biopsies are not the usual way to follow

things. What other labs or tests have you had. Some of them

are probably more important in terms of the CLL. With

melanoma as well the thinking might be different.

A good resource is the LRF booklet (go to

lymphoma.org/booklets) which is free or can be read on line.

Also CLL Topics has a lot of good information. In both cases

don't get too wrapped up in the more advanced stuff. Start

with the material for beginners, and then the things that

apply to your " flavor " of CLL. Things are changing very

quickly as far as treatments, so what you read today may be

old and gone by the time you read it.

Pat

[Guest guest]

Pat,

I live in Florida (near Orlando). Currently, the only

doctors involved is my dermatologist who wanted the surgeon

to do a biopsy. My surgeon was the one that suggested we

wait and see if the node continues to grow and to check a

CBC again in a few months. Thanks for the links...good

information.

Tracey

[Guest guest]

Hi,

See

http://emedicine.medscape.com/article/199313-diagnosis#DifferentialsOtherProblem\

stoBeConsidered

or http://tinyurl.com/4zjoyxq

Copying... if this is correct, follow-up CBC seems standard

practice.

Laboratory Studies

" In patients with chronic lymphocytic leukemia (chronic

lymphoid leukemia, CLL), the complete blood cell (CBC)

counts with differentials show absolute lymphocytosis with

more than 5000 B-lymphocytes/µL **for longer than 3

months.**

Clonality must be confirmed by flow cytometry. The presence

of a cytopenia caused by clonal bone marrow involvement

makes the diagnosis of chronic lymphocytic leukemia (chronic

lymphoid leukemia, CLL) regardless of the peripheral

B-lymphocyte count. "

All the best,

Karl

[Guest guest]

Tracey,

With all due respect to your surgeon, I suggest you listen

to your dermatologist. Melanoma is much more of a threat

than CLL and your best defense against a melanoma metastases

is prompt, and by prompt I mean immediate, analysis. As soon

as you determine that the lymph node has no melanoma cells,

you can worry about the more benign CLL.

Bill

[Guest guest]

If the lymph node is full of CLL cells then the diagnosis is

CLL/SLL. If it has melanoma in it or it is reactive then the

diagnosis is MBL. Let us pray that it is free of melanoma.

Terry Hamblin MD

[Guest guest]

Good advice, Bill. I assumed that the biopsy was a given.

Ruling out melanoma metastases will probably help everyone

in the family relax and move on to dealing with the next

step, CLL wise.

Pat

On 3/27/11, tomocomo <william.pence@...> wrote:

> Tracey,

>

> With all due respect to your surgeon, I suggest you listen

> to your dermatologist. Melanoma is much more of a threat

> than CLL and your best defense against a melanoma metastases

> is prompt, and by prompt I mean immediate, analysis. As soon

> as you determine that the lymph node has no melanoma cells,

> you can worry about the more benign CLL.

>

> Bill

>