Registered Charity 1114037

Normal Blood Counts

What Blood Counts should we monitor?

 

  • White Blood Cell count
  •  

     

  • Neutrophils
  •  

     

  • Basophils
  •  

     

  • Platelets
  •  

     

  • Blasts
  •  

     

  • Hemoglobin
  •  

     

  • Hematocrit
  •  

    What if my blood counts are too low?

    How often should my blood counts be monitored?

    What should my liver counts be?

     

  • Total Protein
  •  

     

  • Albumin
  •  

     

  • ALT (SGPT)
  •  

     

  • AST (SGOT)
  •  

     

  • Alkaline Phosphatase (ALP)
  •  

     

  • Bilirubin
  •  

    What if my liver counts are abnormal?

    How often should my liver counts be monitored?

    Glossary of Terms and Abbreviations

     

    WHAT BLOOD COUNTS SHOULD WE TRACK?

    An individual who has been diagnosed with CML should have routine blood tests, including a Complete Blood Count (CBC) , blood differential and liver function tests (LFTs ), done on a regular basis to help monitor treatment response. The following counts are important to determine one’s clinical status:

     

    COMPLETE BLOOD COUNT AND DIFFERENTIAL:

    A Complete Blood Count (CBC) that measures the number of white blood cells (WBCs) , red blood cells and platelets in the patient's sample of blood should be routinely monitored in CML patients. There are actually five kinds of white blood cells, each with a different function. The five types of white blood cells are monocytes, lymphocytes, basophils , eosinophils and neutrophils . A blood differential that measures the relative numbers of these different kinds of WBCs in the blood and includes information about abnormal cell structure and the presence of blasts or myeloblasts (immature white blood cells) should be done in tandem with the CBC.

    The overall White Blood Cell (WBC) count is important to monitor as a significant elevation in WBC may indicate infection, lack of response to treatment, or worsening of leukemia. Conversely, some treatments for leukemia suppress the WBC and it is important to make sure the WBC does not dip below a critical range. The normal range for WBC is generally from 4.0 to 11.0 k/ul.

    Neutrophils are a type of white blood cell involved in fighting infection. It is important they remain at adequate levels. As with platelets, neutrophil levels may become depressed in patients on myelosuppressive therapy such as imatinib mesylate (also called IM , Gleevec or Glivec ). The normal range of the percentage of neutrophils is between 45% and 70%.

    More important than the percentage of neutrophils is the absolute neutrophil count (ANC) , which should fall between 1.0 to 8.0 k/ul. The reason the ANC represents the true clinical picture better than the percentage of neutrophils is that, in cases where blood counts are suppressed by therapy, the percentage of neutrophils will be higher when the overall counts are low. One may calculate the ANC by multiplying the percentage of neutrophils (in decimal form) plus the percentage of bands (in decimal form) by the total number of white blood cells. The number of bands is usually quite low or even zero, so one may also obtain a fairly accurate ANC by leaving the percent of bands out of the equation

    The Basophils should remain within the normal range, generally between 0% and 2%. Some clinicians believe that, as in the case of neutrophils, the absolute basophil count is more important than the percentage of basophils and should fall between 0 to 0.3 k/ul. The absolute basophil count is calculated by multiplying the percentage of basophils (in decimal form) by the total number of white blood cells.

     

    One should monitor blasts in the peripheral blood . Blasts are immature white blood cells and individuals with leukemia have an excessive number of blasts in their peripheral blood and bone marrow. With appropriate treatment, there should not be any blasts in the peripheral blood and fewer than 5% in a bone marrow aspirate .

    Platelets also constitute an important component in the hematological picture for a CML patient. An escalated and uncontrolled platelet count may indicate disease progression and is cause for concern. In general, with appropriate treatment, platelet levels should fall within the normal range (150 to 450 k/ul) without platelet-lowering medication. Platelet levels may be depressed in patients on myelosuppressive therapy such as IM and it is important they remain at adequate levels.

    Finally, one should keep an eye on hemoglobin and hematocrit counts. If one’s treatment suppresses the counts, it is important not to become too anemic . Normal hemoglobin levels range from 14.0 to 17.0 gm/dL and the hematocrit value should fall between 40.0% and 52.0%.

    When are low counts cause for concern? The answer to that question depends somewhat on the individual patient, the larger clinical picture and the therapy received. In general, for patients on imatinib mesylate therapy ( Gleevec or Glivec ), the following levels may warrant a decrease in dose, an interruption of therapy or the use of growth factors : WBC less than 1.0 k/ul; platelets less than 50 k/ul; hemoglobin less than 10.0 gm/dL; and ANC less than 1.0 k/ul.

    It is important to note that the normal or reference range for blood counts will vary slightly between laboratories, but the following table provides a summary of the normal ranges for the counts discussed above.

     

    Reference Ranges for Peripheral Blood Counts and Differential

     

     

    Reference Range

    Units

    Absolute Count

    White Cell Count

    4.0 – 11.0

    k/ul

    -

    Platelet

    150 - 450

    k/ul

    -

    Basophil

    0 – 2

    %

    0 – 0.3 k/ul

    Blast

    0

    %

    -

    Hemoglobin

    14.0 – 17.0

    gm/dL

    -

    Hematocrit

    40.0 – 52.0

    %

    -

    Neutrophil

    45.0 – 70.0

    %

    1.0 – 8.0 k/ul

     

    How often should CBCs and blood differentials be performed? All patients taking IM should have their blood counts monitored closely. Complete blood counts ( CBCs ) should be monitored weekly in chronic phase patients during the first month of IM treatment. If platelet counts remain over 100,000/mm 3 and absolute neutrophil count (ANC) remains over 1,500/mm 3 , CBC monitoring can be reduced to every two weeks until 12 weeks of IM therapy has been reached. Thereafter, if counts are stable, monitoring may occur monthly or even longer if appropriate. Patients in accelerated or blast crisis should have CBCs performed more often.

     

    LIVER FUNCTION TESTS :

    In addition to monitoring CBCs and blood differentials, it is critical to monitor liver counts through Liver Function Tests (LFTs) , a group of blood tests that can help to show how well a person's liver is working. LFTs include measurements of total protein , albumin , various liver enzymes such as ALT and AST , alkaline phosphatase (ALP) and bilirubin .

    Total Protein measures the amount of proteins in the bloodstream. Normal total protein levels in the bloodstream range from 6.5 to 8.2 gm/dL (grams per deciliter). Two of the main proteins found in the bloodstream are albumin and globulin.

    Albumin is a protein made in the liver. If the liver is badly damaged, it can no longer produce albumin. Albumin maintains the amount of blood in the veins and arteries. When albumin levels become very low, fluid can leak out from the blood vessels into nearby tissues, causing swelling in the feet and ankles. Very low levels of albumin may indicate liver damage. The normal albumin range is from 3.9 gm/dL to 5.0 gm/dL.

    ALT and AST are enzymes made in the liver. They are also called transaminases . ALT is sometimes called SGPT and AST is sometimes called SGOT . The normal range of ALT levels is between 5 IU/L (International Units per Liter) and 60 IU/L. The normal range of AST levels is between 5 IU/L and 43 IU/L. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).

    Alkaline phosphatase (ALP) is another enzyme found in the liver. Abnormally high ALP levels may indicate liver problems. The normal range of ALP is between 30 IU/L and 115 IU/L.

    Bilirubin is a yellow fluid produced in the liver. When bilirubin levels are too high, it can cause a condition called jaundice in which the eyes and skin appear yellow, urine becomes very dark and feces are light. There are two measures of bilirubin: Total Bilirubin, which measures the amount of bilirubin in the bloodstream and Direct Bilirubin, which measures the amount of bilirubin made in the liver. Normal total bilirubin levels range from .20 mg/dL (milligrams per decileter) to 1.50 mg/dL. Normal direct bilirubin levels range from .00 mg/dL to .03 mg/dL.

    When are abnormal liver function tests (LFTs) cause for concern? Any abnormalities in LFTs should be addressed and monitored closely. Current guidelines suggest stopping IM treatment when transaminases (liver enzymes) are more than five times the upper limit of normal. If liver function begins to return to normal, IM may be resumed at a lower dose, then increased to the prior dose in appropriate cases.

    The consumption of alcohol may affect liver function, so it is important to eliminate or moderate one’s alcohol intake while taking IM. Also, acetaminophen (brand name Tylenol) may not be safe to take during treatment with IM since it, also, is metabolized through the liver. One should not take Tylenol or take it only under the guidance of a physician while taking IM.

     

    Reference Ranges for Liver Function Tests

     

    Reference Range

    Units

    Total Protein

    6.5 – 8.2

    gm/dL

    Albumin

    3.9 – 5.0

    gm/dL

    ALT

    5– 60

    IU/L

    AST

    5 - 43

    IU/

    Alkaline Phosphase (ALP)

    30 – 115

    IU/L

    Total Bilirubin

    .20 – 1.50

    mgdL

    Direct Bilirubin

    .00 – .03

    mg/dL

     

    How often should liver function tests (LFTs) be performed? Because of concerns regarding hepatotoxity with IM treatment, LFTs should be obtained before IM treatment is started, every other week during the first month of IM treatment, and at least monthly thereafter. Of course, if any indications of liver problems arise, closer monitoring of LFTs is critical.

    Low Counts : Many patients (<1% to 46%) experience low blood counts while taking IM due to myelosuppression , the inability of the bone marrow to produce an adequate number of cells. All patients taking IM should have their blood counts monitored closely. Complete blood counts (CBCs) should be monitored weekly in chronic phase patients during the first month of IM treatment. If platelet counts remain over 100,000/mm 3 and absolute neutrophil count (ANC) remains over 1,500/mm 3 , CBC monitoring can be reduced to every two weeks until 12 weeks of IM therapy has been reached. Thereafter, if counts are stable, monitoring may occur monthly or even longer if appropriate. Patients in accelerated or blast crisis should have CBCs performed more often.

     

    Myelosuppression due to IM therapy is more common in patients with CML in the accelerated or blast crisis stages, but can also occur in chronic phase patients. Myelosuppression and low counts are evident by low platelet counts ( thrombocytopenia ), low absolute neutrophil counts ( neutropenia ) and/or low red blood cell counts ( anemia ), usually measured by a decrease in hemoglobin . A mild or moderate reduction in counts may require no intervention at all and the counts often recover with continued therapy. In more extreme cases, depending on the type and severity of the myelosuppresion and the phase of CML, a physician may recommend the use of growth factors such as Neupogen (for neutropenia), Neumega (for thrombocytopenia) and Procrit or Aranesp (for anemia); interruption of treatment with IM; or, in some cases, a transfusion. The article referenced below, “Practical Management of Patients with Chronic Myeloid Leukemia Receiving Imatinib,” discusses these options in further detail.
     

    References and further reading :

     


    http://www.healthwise.org/kbasehosp/kbase/topic/medtest/hw4260/results.htm

    http://www.atdn.org/simple/liverfun.html

    http://www.atdn.org/simple/liverfun.html



     

    GLOSSARY OF TERMS AND ABBREVIATIONS

    A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

     

    A

    Absolute Basophil Count - The total number of basophils in a sample of peripheral blood. It is calculated by multiplying the percentage of basophils (in decimal form) by the total number of white blood cells.

    Absolute Neutrophil Count - The total number of neutrophils in a sample of peripheral blood. It is calculated by multiplying the percentage of neutrophils (in decimal form) plus the percentage of bands (in decimal form) by the total number of white blood cells. The number of bands is usually quite low or even zero, so one may also obtain a fairly accurate ANC by leaving the percent of bands out of the equation.

    Accelerated Phase - CML is characterized by two to three phases or stages. The second, intermediate phase is called the Accelerated Phase and usually lasts from 6 to 9 months. The Accelerated Phase does not occur in all patients as some transition directly from Chronic Phase CML to Blast Crisis. Accelerated Phase is characterized by an elevated WBC, but will exhibit one or more of the following markers: greater than 20% basophilia, a hemoglobin level of 7.0 gm/dl or less, platelets 100K/mm3 or less and 15% to 30% myeloblasts. The appearance of myelofibrosis and/or clonal change often indicates progression to Accelerated Phase.

    Albumin - A protein made in the liver. Very low levels of albumin may be a sign of liver damage. The normal albumin range is from 3.9 gm/dL (grams per decileter) to 5.0 gm/dL.

    Alkaline phosphatase (ALP) - An enzyme found in the liver. Abnormally high ALP levels may indicate liver problems. The normal range of ALP is between 30 IU/L and 115 IU/L.

    Allogenic Transplant - Bone marrow or stem cell transplant in which the donor is a matched donor of the patient.

    ALP - Abbreviation for Alkaline Phosphatase, an enzyme found in the liver.

    ALT - An enzyme made in the liver. ALT is sometimes called SGPT. The normal range of ALT levels is between 5 IU/L and 60 IU/L. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).

    Anasarca - A condition of generalized edema or swelling due to excessive fluid retention.

    ANC - Abbreviation for Absolute Neutrophil Count. Normal range is 1.0 - 8.0 k/ul.

    Anemia - a condition in which the number of red blood cells (erythrocytes) is lower than normal. Anemia is usually measured by a decrease in the amount of hemoglobin. A common symptom of anemia is tiredness.

    Aranesp - A long-acting growth factor that can help prevent anemia (low red blood cell and hemoglobin counts), caused by chemotherapy/IM therapy.

    Ascites - A condition in which there is abnormal fluid in the abdomen.

    AST - An enzyme made in the liver. AST is sometimes called SGOT. The normal range of AST leels is between 5 IU/L and 43 I/UL. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).

    Autologous Transplant - A bone marrow or stem cell transplant using the patient's own blood products.


     

    B

    Bands - Immature neutrophils

    Basophil - A type of white blood cell involved in inflammatory and allergic responses. Its role in CML is not well understood, but elevated basophil counts are characteristic of CML. Normal range is 0 - 2.0%.

    Basophilia - Higher than normal number of basophils in the bone marrow or peripheral blood.

    Bcr-Abl - A gene and also a protein created by the translocation of Chromosomes 9 and 22.

    Bilirubin - A yellow fluid produced in the liver. Elevated bilirubin levels can cause a condition called jaundice in which the eyes and skin appear yellow, urine becomes very dark and feces are light. There are two measures of bilirubin: Total Bilirubin, which measures the amount of bilirubin in the bloodstream and Direct Bilirubin, which measures the amount of bilirubin made in the liver. Normal total bilirubin levels range from .20 mg/dL to 1.50 mg/dL. Normal direct bilirubin levels range from .00 mg/dL to .03 mg/dL

    Blasts - Immature white blood cells found in the bone marrow and not normally in the peripheral blood. Also called myeloblasts. Normally there are 0% blasts in the peripheral blood and 0-5% blasts in the bone marrow.

    Blast Crisis - CML is characterized by two to three phases or stages. The third, most severe phase is called the Blast Crisis and lasts from 3 to 6 months. Blast Crisis is characterized by elevated WBC; usually a decreased platelet count, the presence of more than 30% of myeloblasts in the peripheral blood or bone marrow, and tissue infiltrates of leukemic cells which may involve chloromas.

    BMA - Abbreviation for Bone Marrow Aspiration.

    BMB - Abbrevision for Bone Marrow Biopsy.

    BMT - Abbreviation for Bone Marrow Transplant.

    Bone Marrow - The soft, spongy tissue found in the center of most large bones that produces the white cells, red cells and platelets.

    Bone Marrow Aspiration - The removal by suction of fluid from the bone marrow.

    Bone Marrow Biopsy - A method of removing a small sample of bone marrow from the body to have it examined under a microscope and possibly analyzed by other tests.

    bosutinib (Bosulif) - 3rd Generation TKI used to treat Ph+ CML


     

    C

    CBC - Abbreviation for Complete Blood Count.

    Cerebral Edema - A condition in which there is extra fluid and swelling in the brain.

    Chloromas - Collections of tumorous cells within the skin or other body parts.

    CHR - Abbreviation for Complete Hematological Response.

    Chromosomal Damage - Mutations or abnormal changes in a chromosome, often indicative of disease progression.

    Chronic Phase - CML is characterized by two to three phases or stages. The first stage is called the Chronic Phase and usually lasts from 5 to 6 years. The vast majority of patients (85% to 90%) are diagnosed while in the Chronic Phase. Very often, individuals in the Chronic Phase have no or few symptoms and are diagnosed through a routine blood test. Some people in the Chronic Phase experience symptoms such as fatigue, shortness of breath, feeling of fullness or pain in the upper left side of the abdomen (due to enlarged spleen), weight loss, night sweats and anemia. Typical features of Chronic Phase are: elevated white blood cell (WBC) count; normal or high platelet count; increased basophil count; sometimes increased eosinophil count; and, most importantly, fewer than 15% myeloblasts. In the Chronic Phase, as in all three phases of CML, the marrow is usually hypercellular at diagnosis.

    Clonal Change - Abnormal changes within the chromosome, often indicative of disease progression..

    Complete Blood Count (CBC) - The number of white blood cells, red blood cells and platelets in the patient's sample of blood is determined.

    Complete Hematological Response (CHR) - See hematological remission.

    Conventional Cytogenetics - Analysis by microscope if individual cells for the presence or absence of abnormal chromosomes (for example, the Philadelphia Chromsome). The process is very time consuming and is usually conducted on 20 cells.

    Cytogenetic Relapse - A significant increase in the percentage of Philadelphia Chromosome present in the bone marrow or peripheral blood of a CML patient.\

    Cytogenetic Remission - Absense of Philadelphia Chromosome by bone marrow chromosomal analysis, or by FISH analysis of the bone marrow or peripheral blood.

    Cytogenetic Response - The reduction in or the elimination of the number of cells expressing the Philadelphia Chromosome in a CML patient.


     

    D

    dasatinib (Sprycel) - 2nd Generation tyrosine kinase inhibitor used to treat Ph+ chronic myeloid leukemia

    Differential Count - A test that measures the relative numbers of white blood cells (WBCs) in the blood; it also includes information about abnormal cell structure and the presence of immature cells (Blasts or myeloblasts).

    Direct Bilirubin - The amount of bilirubin (a yellow fluid) made in the liver. Normal direct bilirubin levels range from .00 mg/dL to .03 mg/dL. See also Total Bilirubin.


     

    E

    Edema - Swelling due to excessive fluid retention.

    Eosinophilia - Higher than normal number of eosinophils in the bone marrow or peripheral blood.

    Eosinophils - A type of white blood cell involved in allergic responses and parasitic infections.

    Erythrocytes - Red Blood Cells.


     

    F

    FISH - Common abbreviation for Fluoresence In Situ Hybridization. A method using DNA probes for determining many chromosomal abnormalities associated with CML by analyzing peripheral blood or bone marrow. FISH usually looks at 100 or more cells, and is thus more sensitive than conventional chromosomal analysis.


     

    G

    Genotoxic - Chemicals capable of causing damage to DNA.

    Gleevec - A tyrosine kinase inihibitor used to treat chronic myeloid leukemia. Also called imatinib mesylate, IM and Glivec.

    Glivec - A tyrosine kinase inihibitor used to treat chronic myeloid leukemia. Also called imatinib mesylate, IM and Gleevec.

    Graft versus Host Disease - A condition that occurs following bone marrow or stem cell transplant in which the donor's immune cells, in the transplanted marrow, make antibodies against the host's (patient recipient’s) tissues.

    Growth Factors - Agents or medicines that stimulate one’s body to produce certain types of cells (neutrophils, platelets, red blood cells)


     

    H

    Hematocrit - The hematocrit measures how much space in the blood is occupied by red blood cells. It is useful when evaluating a person for anemia. The normal range for hematocrit is 40.0% to 52.0%.

    Hematological Remission - Normal blood counts in a CML patient generally reflected in non-elevated white blood cells, platelets and basophils.

    Hematuria - A condition in which there is blood in the urine.

    Hemoglobin - The red pigment in red blood cells their color. It functions to carry oxygen from the lungs to the rest of the body. The normal range for hemoglobin is 14.0 to 17.0 gm/dL.

    Hepatotoxicity - Condition in which liver function has been harmed by a chemical agent. (Also called liver toxicity.)

    HGB - Abbreviation for hemoglobin.

    HLA (Human Leukocyte Antigens) Typing - A blood test that determines a person's compatability for purposes of a bone marrow or stem cell transplant based on the types of antigens present.

    Hydrea/Hydroxyurea - One of the older anti-cancer drugs. It is often used in newly diagnosed CML patients to destroy the leukemia cells and lower the white blood cell count.

    Hypercellular - In CML, refers to the fact that there is an overabundance of certain kinds of cells in the bone marrow. Hypercellular marrow is particularly common at diagnosis and early in the course of IM treatment in CML patients.

    Hypocellular - In CML, refers to the fact that there is an decreased number of certain kinds of cells in the bone marrow. Hypocellular marrow is particularly common with continued IM treatment in CML patients.


     

    I

    IFN - Abbreviation for interferon.

    Interferon - An agent used to treat CML and other diseases and cancers.

    IM - Abbreviation for Imatinib Mesylate, a tyrosine kinase inhibitor used to treat chronic myeloid leukemia (CML). Also called Gleevec and Glivec.

    Imatinib Mesylate - A tyrosine kinase inihibitor used to treat chronic myeloid leukemia. Also called IM, Gleevec and Glivec.


     

    K

    Karyotypic Evolution - Abnormal changes within the chromosome, often indicative of disease progression.


     

    L

    Leukocyte - A white blood cell.

    LFTs - Abbreviation for Liver Function Tests.

    Liver Function Tests - a group of blood tests that can help to show how well a person's liver is working. LFTs include measurements of albumin, various liver enzymes (ALT, AST, GGT and ALP), bilirubin, prothrombin time, cholesterol and total protein. All of these tests can be performed at the same time

    Liver Toxicity - Condition in which liver function has been harmed by a chemical agent. Also called hepatotoxicity.


     

    M

    Major Cytogenetic Response (MCR) - A reduction in the percentage of cells expressing the Philadelphia Chromosome to 35% or less in a CML patient.

    Minor Cytogenetic Response - A reduction in the percentage of cells expressing the Philadelphia Chromosome to a level between 36%-95% in a CML patient.

    Molecular Remission - Absence of Bcr-Abl transcripts in the peripheral blood or bone marrow by PCR testing. This is the highest degree of remission for CML patients to achieve.

    MR - Abbreviation for Molecular Remission.

    MUD - Abbreviation for Matched, Unrelated Donor (for bone marrow or stem cell transplant). This is a non-family member whose HLA matches the patients’ HLA.

    Myeloblasts - An immature cell found in the bone marrow and not normally in the peripheral blood. Normally there are 0% myeloblasts in the peripheral blood and 0-5% blasts in the bone marrow.

    Myelofibrosis - A condition in which the marrow of the bone is replaced with fibrous (scar) tissue.

    Myelosuppression - A decrease in the ability of the blood cell-producing tissues of bone marrow to produce all types of blood cells.

    Myelosuppressive - Causes a decrease in the ability of the bone marrow to produce cells.


     

    N

    Neumega - A platelet growth factor that can help prevent extremely low platelet counts caused by chemotherapy/IM therapy.

    Neupogen - A growth factor that can help prevent extremely low neutrophil counts caused by chemotherapy/IM therapy.

    Neutropenia - The condition of having abnormally low numbers of one type of white blood cell called neutrophils.

    Neutrophil - A type of white blood cell largely responsible for fighting infection. Normal range for neutrophils is 45.0% to 70.0%.

    Nilotinib (Tasigna) - A 2nd Generation tyrosine kinase inhibitor used to treat Ph+ chronic myeloid leukemia


     

    P

    PCR - Common abbreviation for Polymerase Chain Reaction. A very sensitive test used to detect very low levels of bcr-abl transcripts in marrow or peripheral blood stem cells. The test involves analysis of bone marrow or peripheral blood to determine the presence and/or percentage of Bcr-Abl transcripts.

    Peripheral Blood - The blood that circulates throughout the body.

    Ph or Ph+ - Abbreviation for Philadelphia Chromosome and Philadelphia Chromosome positive (meaning that the Philadelphia Chromosome is present)

    Philadelphia Chromosome - Refers to the short chromosome 22 which occurs when part of chromosome 22 breaks off and attaches to chromsome 9. This chromosomal mutation is characteristic of most patients (85%) with CML.

    Platelet Transfusion - The process of giving platelets from a donor to a patient with very low platelets.

    Platelets - A type of blood cell formed in bone marrow that helps prevent bleeding by causing blood clots to form. Normally, platelet counts range from 150 to 450 k/ul.

    Pleural or Pericardial Effusion - A condition in which fluid surrounds the cavity around the heart.

    Ponatinib (Iclusig) - 3rd Generation TKI used to treat Ph+ CML, effective against T315i mutation

    Procrit - A growth factor that can help prevent anemia (low red blood cell and hemoglobin counts), caused by chemotherapy/IM therapy.

    Pulmonary Edema - A condition in which there is fluid in the lungs.


     

    Q

    Qualitative PCR - A very sensitive test that detects the presence or absence of Bcr-Abl in the marrow or peripheral blood.

    Quantitative PCR - A very sensitive test that detects the percentage of Bcr-Abl in the marrow or peripheral blood


     

    R

    Red Blood Cells - Cells that carry oxygen to all parts of the body through hemoglobin.

    Reference Range - The lower and higher end of values considered normal for a laboratory test. All laboratory results which show counts at the lower or higher ends, or anywhere in between, are considered normal.

    Relapse - A loss of response, usually marked by the loss of hematological remission, an increase in the percentage of Philadelphia chromosome or a significant increase in the percentage of Bcr-Abl transcripts in a CML patient.

    Remission - A decrease in, or disappearance of, signs and symptoms of an illness. In partial remission, some, but not all, signs or symptoms of cancer have disappeared. In complete remission, all signs or symptoms of cancer have disappeared, although there still may be cancer in the body


     

    S

    SCT - Abbreviation for Stem Cell Transplant.

    SGOT - An enzyme made in the liver. SGOT is sometimes called AST. The normal range of SGOT leels is between 5 IU/L and 43 I/UL. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).

    SGPT - An enzyme made in the liver. SGPT is sometimes called ALT. The normal range of SGPT levels is between 5 IU/L and 60 IU/L. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).

    Spleen - A large organ to the left of the stomach and below the diaphragm, serving to store blood, disintegrate old blood cells, filter foreign substances from the blood, and produce lymphocytes(white blood cells).

    Stem Cells - Cells from which other types of cells can develop.

    Stem Cell Transplant - Procedure to replace the diseased bone marrow from a sick patient with the healthy stem cells from a donor.


     

    T

    Thrombocytopenia - The condition of having abnormally low numbers of platelets.

    Thrombocytosis - The condition of having abnormally high numbers of platelets.

    Tissue Infiltrates - Tumorous cells that invade the skin or other body parts.

    Total Bilirubin - Measures the amount of bilirubin (a yellow fluid made in the liver) in the bloodstream. Normal total bilirubin levels range from .20 mg/dL to 1.50 mg/dL. See also Direct Bilirubin.

    Total Protein - The amount of proteins in the bloodstream measured in liver function tests (LFTs). Normal total protein levels in the bloodstream range from 6.5 to 8.2 gm/dL

    Transaminases - Enzymes made in the liver. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).

    Translocation - In terms of cancer, refers to parts of chromosomes breaking off and switching places with each other, thereby causing abnormal function (see Philadelphia Chromosome)


     

    W

    WBC - Abbreviation for White Blood Cell.

    White Blood Cell - A blood cell that does not contain hemoglobin. White blood cells are made by bone marrow and help the body fight infection and other diseases, as part of the immune system.

    White Blood Cell (WBC) Count - Counting the number of white blood cells, usually as part of a complete blood count (CBC). Normally, WBC should range between 4.0 and 11.0 k/ul.


     

    Some definitions and descriptions were taken directly from http://www.phoenix5.org/glossary/glossary.html