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I Had An Appointment With A Hematologist/ Oncologist Today Due

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Posted on Tue, 1 Oct 2019
Question: I had an appointment with a hematologist/oncologist today due to abnormal CBC results, specifically elevated platelet counts (previous readings 675, 829, 772 and from today's appointment 748). WBC has previously been elevated at 14.5 and 12.4 with today's result 11.8. RBC has been 5.89, 5.59 and today 5.71. MCV has been has previously been low at 77.1 and today 77.4. MCH previously low at 24.7 and today 24.3. RDW-CV previously 17.4, 16.8 and today 19.3. Hemoglobin, hematocrit. MCHC and MPV have remained within normal parameters. Also of note from today's labs: Neutrophils: 74%, Lymphocytes 17%, Monocytes 3%, Eosinophils 2%, Basophils 1%, Band 3%, Cells counted 100# cells, Platelet estimation: increased, WBC Morph: normal, Microcytosis: normal, Large platelets: normal. Please give me your clinical observations as well as your potential diagnoses. Thank you for your time.

I should note that the MD drew blood today for JAK2 reflex, bcr abl peripheral blood, LDH, iron studies, ESR and CRP. An explanation of these tests and what they are looking for would also be much appreciated. Again, thank you for your time.
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Answered by Dr. Dr. Ivan Romich (24 hours later)
Brief Answer:
no need to worry

Detailed Answer:
Hi and welcome to HCM.
The only abnormal finding is thrombocytosis.Slightly elevated WBC is not indicating any disease and it may be sign of any previous infection or inflammation in body including minor respiratory infections. Platelet count is moderately high, but should be evaluated and followed. This may also beso called reactive thrombocytosis as a consequence of infection or stress.

Other results are fine so you shoul dnot be afraid of some more serious hematologic disease such as lymphoma or leukemias.

LDH, CRP and ESR are used to evaluated infections or inflammatory processes in body. JAK-2 testing is used to rule out Polycitemia rubra which is disease that affects red blood cells, but I dont think this will be positive in your case since RBC and Hgb would be very high. Similarly, BCR-ABL is genetic test used to rule out chronic leukemia, but I need to highlight that these tests are done for every patients as a part of hematologic work up just to rule out the worst and you should not be concerned since these findings are not indicating some of these serious issues.

Thank you . Wish you a very good health.
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Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13888 Questions

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I Had An Appointment With A Hematologist/ Oncologist Today Due

Brief Answer: no need to worry Detailed Answer: Hi and welcome to HCM. The only abnormal finding is thrombocytosis.Slightly elevated WBC is not indicating any disease and it may be sign of any previous infection or inflammation in body including minor respiratory infections. Platelet count is moderately high, but should be evaluated and followed. This may also beso called reactive thrombocytosis as a consequence of infection or stress. Other results are fine so you shoul dnot be afraid of some more serious hematologic disease such as lymphoma or leukemias. LDH, CRP and ESR are used to evaluated infections or inflammatory processes in body. JAK-2 testing is used to rule out Polycitemia rubra which is disease that affects red blood cells, but I dont think this will be positive in your case since RBC and Hgb would be very high. Similarly, BCR-ABL is genetic test used to rule out chronic leukemia, but I need to highlight that these tests are done for every patients as a part of hematologic work up just to rule out the worst and you should not be concerned since these findings are not indicating some of these serious issues. Thank you . Wish you a very good health.