Hello, dear doctors! If it is possible, please consult....

[Elena]

Hello, dear doctors! If it is possible, please consult.. The patient, 76 years, diagnosis HLL, besides it or this for a long time has an ischemic heart disease, an atherosclerosis, a hypertonia of 2 degrees. The analysis of a blood from 20.06.01: a hemoglobin - 79, erythrocytes - 2, 93, an average haemoglobin content in 1 erythrocyte - 27. Thrombocytes - 147, leucocytes - 67, 5, segmented - 2, eosinocytes - 1, lymphocytes - 93, monocytes - 2, soe - 17, shadows B-G 1 3. It is appointed or nominated: vitamins 1, 6, With; iron preparations, Prednisolonum. The analysis of a blood from 23.07.01: a hemoglobin - 85, erythrocytes - 3, 42, an average haemoglobin content in 1 erythrocyte - 22, thrombocytes - 218, leucocytes - 113, 5, band - 1, segmented - 1, lymphocytes - 95, monocytes - 2, soe - 6, shadows B-G 3 5. In a week, 01.08.01
Have made one more analysis of a blood: a hemoglobin - 105, erythrocytes - 3, 76, an average haemoglobin content in 1 erythrocyte - 28, thrombocytes - 226, leucocytes - 122, band - 1, segmented - 2, eosinocytes - 1, lymphocytes - 94, monocytes - 2, soe - 4, shadows B-G 1 3. As a result of treatment the state of health has improved, lymphonoduses have decreased in sizes and became softer.
Tell or Say, than such body height of the leucocytes, what treatment you is caused could recommend and as you estimate or appreciate its or her status. Thanks.

[Doronin V.A.]

Proceeding from the given analyses it is possible to speak about III stage of a chronic lymphoid leukosis on classification Rai. In the June analysis (in the others to a lesser degree) the quantity or amount of erythrocytes and a hemoglobin is lowered. Unfortunately, to express precisely the reason of an anemia it is difficult. It is necessary to know some additional parameters (at least, reticulocytes and a bilirubin) what to exclude autoimmune character of an anemia, that often happens at HLL. In a world or global practice at presence of an autoimmune hemolitic anemia appoint or nominate Prednisolonum, in its or his other cases try to not appoint or nominate (at least in the beginning of therapy). In the given situation, considering fast enough body height of quantity or amount of leucocytes cytostatic treatment is necessary. The most widespread preparation - Leukeranum. And all tactics of conducting you should discuss certainly details of treatment with the attending physician as high-grade correspondence consultation, without the patient and knowledge of all details of a situation, is impossible.

[Elena]

Many thanks for the answer. The matter is that we in city do not have the oncologist, especially hematologist... What analysis should be made to find out reticulocytes and a bilirubin? Thanks.

[Doronin V.A.]

Reticulocytes are considered within the limits of the general or common analysis of a blood. The bilirubin is defined or determined in the biochemical analysis of a blood.