| Introduction
Measuring
WBCs
Myeloid
Leukemias
Lymphoid
Leukemias
Sources
of Error
Quiz
Please |
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So
you've got a patient with a high white count.
-
Some people with serious infections
can have very high white counts (it's called a "leukemoid reaction").
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Here are some simple things
you can do short of a bone marrow.
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Leukocyte alkaline phosphatase
(LAP).
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An enzyme found in PMNs,
and used to generate oxide ions for bacterial killing.
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We actually look at the activity
in the PMN itself, this is not a serum enzyme measurement.
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A low score (<50)
says the white cells are sick.
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A high score (>120,
theoretical maximum is 400), says the polys are fired up and reactive.
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Serum vitamin B12 level.
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Levels actually rise in leukemia
(seems
paradoxical, but true).
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One of the serum transport
proteins for B12 is manufactured in PMN precursors.
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As the malignant cells proliferate
and die, they release large amounts of the transport protein.
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The B12 stores in the liver
are displaced to the serum protein, leading to the elevated level.
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Look for the BCR-ABL
gene product.
The bone
marrow in CML
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