Tag Archives: biopsy

CLL Vocabulary Lesson

There are many words I use in posts here that I never used prior to CLL entering my life. May this glossary help understanding some of the alphabet soup of clinical terms that frequently appear here.

Anemia [n]: A pathological deficiency in the oxygen-carrying component of the blood, measured in unit volume concentrations of hemoglobin, red blood cell volume, or red blood cell number.
Antibody [n]: Any of various proteins produced in the blood in response to the presence of an antigen. By becoming attached to antigens on infectious organisms antibodies can render them harmless or cause them to be destroyed See also immunoglobulin
Bone Marrow Biopsy (BMB) [n]: The removal of a sample of bone marrow and a small amount of bone through a large needle. Two samples are taken. The first is bone marrow by aspiration (suction with a syringe). The second is a core biopsy to obtain bone marrow along with bone fibers. After the needle is removed, this solid sample is pushed out of the needle with a wire. Both samples are examined under a microscope to examine the cells and the architecture of the bone marrow.
Chemistry Screen [n]: A chemistry screen is a blood test that measures the levels of several substances in the blood.

  • Albumin.
  • Alkaline Phosphatase.
  • Alanine Aminotransferase (ALT).
  • Aspartate Aminotransferase (AST).
  • Bilirubin (total and direct).
  • Blood Glucose.
  • Blood Urea Nitrogen.
  • Calcium (Ca) in Blood.
  • Carbon Dioxide (Bicarbonate).
  • Chloride (Cl).
  • Cholesterol and Triglycerides Tests.
  • Creatinine and Creatinine Clearance.
  • Gamma-Glutamyl Transferase (GGT).
  • Lactate Dehydrogenase.
  • Phosphate in Blood.
  • Potassium (K) in Blood.
  • Sodium (Na) in Blood.
  • Total Serum Protein.
  • Uric Acid in Blood.

CBC (Complete Blood Count) [n]: A diagnostic test which measures:

  • The number of red blood cells (RBC count)
  • The number of white blood cells (WBC count)
  • The total amount of hemoglobin in the blood
  • The fraction of the blood composed of red blood cells (hematocrit)

CT Scan [n]: A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body.
Immunoglobulin [n]: Any of a group of large glycoproteins that are secreted by plasma cells and that function as antibodies in the immune response by binding with specific antigens. There are five classes of immunoglobulins: IgA, IgD, IgE, IgG, and IgM.
Lymphadenopathy [n]: Chronically swollen lymph nodes.
Lymphocyte [n]: Any of the nearly colorless cells found in the blood, lymph, and lymphoid tissues, constituting approximately 25 percent of white blood cells and including B cells, which function in humoral immunity, and T cells, which function in cellular immunity.
Lymphocytosis [n]: An abnormal increase in the number of lymphocytes in the blood.
Monoclonal Antibody [n]: Any of a class of antibodies produced in the laboratory by a single clone of cells or a cell line and consisting of identical antibody molecules
Neutropenia [n]: An abnormal decrease in the number of neutrophils in the blood.
Splenomegaly [n]: Enlargement of the spleen.
Thrombocyte (also known as platelet) [n]: A minute cell occurring in the blood of vertebrates and involved in clotting of the blood
Thrombocytopenia [n]: An abnormal decrease in the number of blood platelets.

Please let me know if I’ve missed anything.

Less Biopsy Pain

Leukemias are cancer subtypes of the bone marrow tissue and I’ve had two bone marrow biopsy (BMB) procedures performed so far; both the old fashioned way with a Jamshidi needle.

jamshidiIt’s barbaric but thankfully I was anesthetized each time. Many patients get it done w/o anesthesia and it is immensely painful to have done. There’s a newer, less barbaric product on the market called On Control that looks wonderful. The promise is a faster sample collection with less bone marrow biopsy pain. The only problem I’ve noted is you don’t generally get much opportunity to consult with the pathologist or interventional radiologist performing the procedure to request or ask if they use it. I’d love to talk to some patients who have had a BMB performed with one. Check it out.

Planetary Alignment

Sarah Cannon

The planets must have been a bit out of alignment yesterday. The calendar held a full day w/ 1 Dr visit, one biopsy w/ anesthesia and 1 set of CTAs (Computed Tomography Angiograms). At the last moment, the pathologist scheduled to obtain my marrow sample decided to have the biopsy guided by CT (different doctors, different part of hospital) which pushed the planned CTA procedure into scheduling peril.

CT_Guided_Bone_Biopsy

I was released from the hospital three hours later than planned at 530pm and the imaging folks just one half mile away were supposed to wait for us. They didn’t but apparently they were nice enough left the doors unlocked. We set off an alarm upon entering. Some very friendly radiologists came up to investigate the alarm a few minutes later. They advised us to call the practice tomorrow and reschedule and I finally got to eat. :-).

The CTA is still needed to stage my CLL for the treatment/clinical trial scheduled to begin later this week. Until then, I am once again “nil per os”. Here’s to hoping the planets are in a little better alignment today.

Chapter One

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Hi! I’m Don. I was diagnosed with Chronic Lymphocytic Leukemia (aka CLL) in September of 2011. Since then, we’ve done lots of bloodwork and a bone marrow biopsy in something known in clinical circles as “watch and worry”. We’ve steadily and patiently watched my white blood cell counts rise and my red blood cell & platelet counts fall.My lymph nodes have gotten pretty big and in general, I am fatigued and don’t feel really good most days.

Fast forward to August, 2013.

This week, my platelet count had fallen to 74000 so my oncologist Dr Flinn and I both agreed that it was time to begin treatment. I have a genetic mutation called short arm chromosone 17p deletion. FCR (Fludarabine + Cyclophosphamide + Rituxan) is the standard chemotherapy regimen for CLL these days but it’s not known to be all that effective in terms of achieving durable remissions for those of us in the 17p club. Without a bone marrow/stem cell transplant, this is not generally considered a curable cancer and managing it over the long term is what we’ll have to do. We looked at some new therapy options and I believe we found a good fit. It’s all unfolding really fast and in the last few days, I’ve enrolled in a clinical trial for a new B cell receptor pathway signalling inhibitor currently called ipi-145. I will begin treatment next week. We’re gonna drop-kick this cancer with zero mercy! This is where the story begins.

drop-kick