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I Am Being Treated By An Oncologist/ Hematologist And I

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Posted on Wed, 16 Oct 2019
Question: I am being treated by an Oncologist/Hematologist and I have been reading and just wanting some additional information about my problem. In Dec 2018 I was diag with Chronic Lymphocytic Leukemia and that diagnosis has been hard for me to accept. It is hard to just do nothing. In addition to that diag I am being watched for high Ferritin levels. In Feb 2019 I had my Iron checked and the numbers are as follows Total Iron 223H, Transferrin 207, TIBC 259, Ferritin 375.6 H and Iron Sat Calc 86% H. My doctor ran my Ferritin again on Sept 25 and it was 618!! He is not too concerned yet but said he will check me for hemochromatosis at next visit if my levels remain high. I do not have a family history. I do not drink and I am about 15 lbs over weight and that came on this year due to some mild depression over the CLL diag. I am now trying to get back on track. I normally exercise with a cardio/strength training program 5 x wk for 20-30 minutes. I also have a dog that I talk on walks and run in the yard with. From what I read this goes up due to inflammation, obesity and or drinking. My chemistry labs are all good liver and kidney tests are in normal ranges and so is my blood sugar. I am just trying to figure out why I have this high lab result and what can I do if anything. How likely is it hemochromatosis? What can you share with me that might help me to understand this test result? Thanks.
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Follow up: Dr. Shailja Puri (0 minute later)
I am being treated by an Oncologist/Hematologist and I have been reading and just wanting some additional information about my problem. In Dec 2018 I was diag with Chronic Lymphocytic Leukemia and that diagnosis has been hard for me to accept. It is hard to just do nothing. In addition to that diag I am being watched for high Ferritin levels. In Feb 2019 I had my Iron checked and the numbers are as follows Total Iron 223H, Transferrin 207, TIBC 259, Ferritin 375.6 H and Iron Sat Calc 86% H. My doctor ran my Ferritin again on Sept 25 and it was 618!! He is not too concerned yet but said he will check me for hemochromatosis at next visit if my levels remain high. I do not have a family history. I do not drink and I am about 15 lbs over weight and that came on this year due to some mild depression over the CLL diag. I am now trying to get back on track. I normally exercise with a cardio/strength training program 5 x wk for 20-30 minutes. I also have a dog that I talk on walks and run in the yard with. From what I read this goes up due to inflammation, obesity and or drinking. My chemistry labs are all good liver and kidney tests are in normal ranges and so is my blood sugar. I am just trying to figure out why I have this high lab result and what can I do if anything. How likely is it hemochromatosis? What can you share with me that might help me to understand this test result? Thanks.
doctor
Answered by Dr. Shailja Puri (17 hours later)
Brief Answer:
Bone marrow aspiration and biopsy recommended

Detailed Answer:
Hello,

Chronic lymphocytic leukemia (CLL) has an indolent course and the disease responds well to chemotherapy. I hope you are taking treatment for CLL.

The iron profile is deranged and is suggestive of iron overload. Hemochromatosis is a condition associated with iron overload and abnormal deposition of iron in various organs. A bone marrow aspiration and biopsy is necessary in this case - to confirm the cause. I am glad you have an appointment with the doctor (hematologist) soon. I will suggest you discuss about bone marrow aspiration and biopsy.

In addition to bone marrow examination, all organ systems needs to be screened. I will also suggest to get thyroid function tests, lipid profile and cardiac evaluation.
You may also get molecular studies for HFE gene to look for any mutation of HFE gene which leads to hereditary hemochromatosis.

Hope this suffices.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Shailja Puri (0 minute later)
Brief Answer:
Bone marrow aspiration and biopsy recommended

Detailed Answer:
Hello,

Chronic lymphocytic leukemia (CLL) has an indolent course and the disease responds well to chemotherapy. I hope you are taking treatment for CLL.

The iron profile is deranged and is suggestive of iron overload. Hemochromatosis is a condition associated with iron overload and abnormal deposition of iron in various organs. A bone marrow aspiration and biopsy is necessary in this case - to confirm the cause. I am glad you have an appointment with the doctor (hematologist) soon. I will suggest you discuss about bone marrow aspiration and biopsy.

In addition to bone marrow examination, all organ systems needs to be screened. I will also suggest to get thyroid function tests, lipid profile and cardiac evaluation.
You may also get molecular studies for HFE gene to look for any mutation of HFE gene which leads to hereditary hemochromatosis.

Hope this suffices.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Shailja Puri (2 hours later)
Thank you. My doctor is going to run more tests in December. I just wanted to understand iron overload better. In the US we don't do bone marrow biopsy with my iron numbers or chemo for cll. I am unmutated and when it is time for treatment for cll they will do a bone marrow before treatment is chosen. My doctor is planning on the gene testing if my iron numbers remain high. All of my organ systems have been checked and are okay right now. I appreciate your feedback.
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Follow up: Dr. Shailja Puri (0 minute later)
Thank you. My doctor is going to run more tests in December. I just wanted to understand iron overload better. In the US we don't do bone marrow biopsy with my iron numbers or chemo for cll. I am unmutated and when it is time for treatment for cll they will do a bone marrow before treatment is chosen. My doctor is planning on the gene testing if my iron numbers remain high. All of my organ systems have been checked and are okay right now. I appreciate your feedback.
doctor
Answered by Dr. Shailja Puri (13 hours later)
Brief Answer:
Gene testing will help to diagnose iron overload.

Detailed Answer:
Hello and welcome again,
Gene testing will help to diagnose in case there is familial iron overload.
In case bone marrow aspiration is done for CLL, the iron stores can be assessed.
Its good that all organ systems are fine.

Thanks and take care
Dr Shailja Puri
KINDLY HIT THANKS
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Shailja Puri (0 minute later)
Brief Answer:
Gene testing will help to diagnose iron overload.

Detailed Answer:
Hello and welcome again,
Gene testing will help to diagnose in case there is familial iron overload.
In case bone marrow aspiration is done for CLL, the iron stores can be assessed.
Its good that all organ systems are fine.

Thanks and take care
Dr Shailja Puri
KINDLY HIT THANKS
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 9705 Questions

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I Am Being Treated By An Oncologist/ Hematologist And I

I am being treated by an Oncologist/Hematologist and I have been reading and just wanting some additional information about my problem. In Dec 2018 I was diag with Chronic Lymphocytic Leukemia and that diagnosis has been hard for me to accept. It is hard to just do nothing. In addition to that diag I am being watched for high Ferritin levels. In Feb 2019 I had my Iron checked and the numbers are as follows Total Iron 223H, Transferrin 207, TIBC 259, Ferritin 375.6 H and Iron Sat Calc 86% H. My doctor ran my Ferritin again on Sept 25 and it was 618!! He is not too concerned yet but said he will check me for hemochromatosis at next visit if my levels remain high. I do not have a family history. I do not drink and I am about 15 lbs over weight and that came on this year due to some mild depression over the CLL diag. I am now trying to get back on track. I normally exercise with a cardio/strength training program 5 x wk for 20-30 minutes. I also have a dog that I talk on walks and run in the yard with. From what I read this goes up due to inflammation, obesity and or drinking. My chemistry labs are all good liver and kidney tests are in normal ranges and so is my blood sugar. I am just trying to figure out why I have this high lab result and what can I do if anything. How likely is it hemochromatosis? What can you share with me that might help me to understand this test result? Thanks.