Step I red count in CML

[johndoe3344]

Pathoma said that (in general) with a myeloproliferative disorder, cells of all myeloid lineages are increased. Is there an exception? That is, in CML, would the red count be higher or lower?

 

[mdeast]

Pathoma said that (in general) with a myeloproliferative disorder, cells of all myeloid lineages are increased. Is there an exception? That is, in CML, would the red count be higher or lower?

I think it can vary to be honest. In other words, you could have an increased, normal, or decreased RBC count (or other lineage counts) in any of the proliferative disorders. For example, one of the diagnostic criteria for CML is a platelet count either below 100k or above 1000k. It probably depends on which lineages the specific disorder favors that probably relate to the exact stage of development of the cancer cell that originated the process. In the case of CML...i.e. which stage of development did a cell develop the BCR-Abl fusion protein 9;22 translocation. Things like CML tend to favor granulocytes. Whereas, polycythemia vera favors RBC lineages, etc.

So in other words, I think it varies. But, it's possible that RBC count could be increased in any of these disorders. I think Pathoma is right in that, as a rule, yes, most if not all myeloid lineages are increased in these disorders. Some are just much more increased that others.

 

[johndoe3344]

I think you're right that it varies.

I came across an Rx question (hence my question) where they presented a 65 year old guy with 4 month history of fatigue and dyspnea on exertion. They then showed a peripheral blood smear of CML and asked what his WBC/RBC/platelet counts would be.

I guess I should've figured out that it was most likely the decreased red count --> anemia causing the fatigue and DOE, and not just automatically jumped to say CML = high red count.

 

[shan564]

You can get anemia in advanced disease when the bone marrow is producing so many white cells that the red cells are crowded out.