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Alert Number 98

Don't Waste Your Money

Date: June 8, 2005

I have just heard from Dr. Maher Albitar of Quest Diagnostics. He is pleased that our patients are finding the Quest prognostic packages useful, but he has run into a bit of a problem with a few patients. (Never heard of the Quest Prognostic Packages? Fie on you. We and they worked our fingers to our bones getting these packages expedited and ready for your use. Click on the links below for a run down on how to get a good fix on your particular version of CLL).

Here is the problem. These are all blood tests, based on looking at the CLL cells in your blood samples. Suppose you have just had therapy, and your blood is squeaky clean with 'most every CLL cell killed and disposed of. You probably still have residual CLL in bone marrow and lymph nodes and you are not likely to be fully 'cured' (sorry!), but chances are that if the therapy did much of anything for you, your blood has none of the CLL blighters for a period of time - until they manage to grow back again. Now if you send samples of the freshly cleaned blood right away to Quest, they are not going to be able to find CLL cells to test! You get my drift? There have to be a reasonable number of CLL cells in your peripheral blood for the tests to work. This problem can also surface for the eager beaver and very newly diagnosed patient with hardly any CLL cells in their blood, yet. Save your money and wait until there is some point in sending off the blood samples. OK?

As a very rough rule of thumb, I would guess you will not get much joy from getting the Prognostic Tests done if your WBC is less than 13.0. The normal WBC range for most labs is around 5.0 to 10.0. Basically, you need to be at least 30% over the maximum of the normal range for WBC. If you have just finished therapy, relax, you are not going to face new therapy choices right away and you can afford to wait until the WBC climbs back up 30% or more above the high end of the normal range before you get the prognostic testing done. If you are a newly diagnosed CLL patient, hold your horses! If your numbers are so low that Quest cannot find enough CLL cells in your blood to do the tests, what is the hurry? You have time to read, learn, enjoy your life, before you get going on all this stuff.

Prognostic and Monitoring Test Packages;
Progress on Prognostics;
Also: Topics Alert Number 88, Dated April 20, 2005.

Be well,

Chaya
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