Confused about CBC blasts

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• May 5, 2007 at 8:53 pm #18020
  jonelle

  Member

  I may be under a misconception that there is a line on the CBC where blasts are listed. Since none appear on my Husbands tests I am assuming that there aren’t any in the blood.
  Am I correct or is there a formula to determine blast count by using the other components? Thanks.

  May 5, 2007 at 9:54 pm #18021
  jga_socal

  Member

  I think they get peripheral blasts counts from a ‘slide review’ using the CBC sample. Normally a slide review is triggered by something abnormal the automated instruments detect but a doctor can also order a slide review separately. In a slide review they will grid off an area and manually count all cells, abnormal cells, blasts, etc… coming up with blasts%. With a bone marrow biopsy they do a similar manual count but they can also do a machine count. I dont know if both counts are required. My hosp bill came in last week and the bmb charge came to $5k. This seems rather drastic for a 15 minute procedure, so I assume the lab analysis is an expensive component. At any rate, distribution of abnormal cells in bone marrow is not uniform. If blasts from your tail bone come in at 10% that should be considered one sample. Other samples may come in higher or lower. Myself, I only want to pay for the one sample, in pain and dollars. I’m only relaying to you answers I’ve obtained from asking my doctors similar questions.
  Jim

  May 5, 2007 at 9:58 pm #18022
  Jack_dup1

  Member

  Jonelle,
  We I had my weekly CBC at my local hematogolist and I had blasts, it did not show up on the list, when I had them done at the Center of Excellence, they were listed, but only if I had blasts, now that my blasts are at zero, it is not on the list.
  I think if the local doctor had requested blasts, they would have done it.
  Jack

  May 6, 2007 at 2:14 am #18023
  patti

  Member

  Jim,

  Ummm, don’t be surprised if you get a second bill from the laboratory for the biopsy reading. These are usually separate from the hospital/doctors bill for doing the biopsy. If the hospital lab did the reading there will be a line item on your bill for lab reading services (there is a technical name). If it’s not there, you’ll likely get one more bill. Yep, very spendy.

  patti

  May 6, 2007 at 5:14 am #18024
  SandyB

  Member

  Every one of Mike’s CBC’s has a category listed as MID Cells. Those are a combination of Monocytes, Esophils, Basophils, Blasts and so forth. These are just normal CBC’s without Differentials.

  May 6, 2007 at 6:19 am #18025
  patti

  Member

  Sandy,

  MID cells are not the same as blast cells. The breakdown you are seeing of basophils, etc. are the 5 types of white cells that make up the total white cell count. Blast cells can only be seen under microscope and therefore are not on a standard CBC print out. If his blast count is listed it would only be because they have it in there from a slide test they either did that day or previously and put it in the computer to print out with the CBC.

  Hope this helps,

  patti

  May 6, 2007 at 5:14 pm #18026
  SandyB

  Member

  Patti:

  Thank you for the advice, but I am going to go with what my Dr. says and what is printed in black and white on the test results.

  I think maybe the fine line is getting broken more and more.

  Sandy

  May 7, 2007 at 1:16 pm #18027
  Russ P.

  Member

  On my CBCs I was given a quicky report that did not include blasts. It was only later that a differential report showed the blasts among other things.

  May 7, 2007 at 10:12 pm #18028
  jaxem

  Member

  hmmn
  blast listing on a cbc printout? like others have said, the only way to count blasts are by manually counting them off a slide, or running a sample through a flow cytometer which runs the costs up, & is why it’s usually only done after a bmb.

  i’ve never seen MID’s on a cbc but have seen each cell type specifically spelled out.

  May 11, 2007 at 4:16 am #18029
  Jack_dup1

  Member

  I just had my CBC with diff drawn one hour before Dr Appoint. The printout listed
  Blast 1%, Metamyelocyte 4% i don’t know about this one, and of course the Lymph 12%, Neu Seg and Band 71%, Monocyte 10%, eso and baso 1%
  And it listed the usual subjets, Whites 18.9. Platelets 77, reds normal.
  Jack

  May 11, 2007 at 10:10 pm #18030
  jonelle

  Member

  My husband was scheduled to have a CBC a few days ago. I specifically requested from the Dr that a slide review for blast cell count be done.
  Got the results today and the Dr casually mentioned to my Hb that there were 1% to 2% blasts detected. However, I noticed that it doesn’t appear on the CBC print out.
  How can he throw a number out there without any indication on the test?
  Unfortunately, we have a Mom & Pop business. While Pop is at the Dr, Mom must be at the shop. I got the info too late to get in touch w/Dr.
  Sorry to vent – but I am disgusted… I wish my Hb would be more interested in keeping up with the pertinent info.

  May 12, 2007 at 12:34 am #18031
  patti

  Member

  Jonelle,

  Again, MOST CBC’s do not list the blast count. These ones that have it listed I think are in the minority. Also, it depends on where that 1-2% of blasts are. Are they in the peripheral blood? Or the marrow? In the marrow (which can only be seen from a BMB) anything less then 5% is normal.

  Some people just deal with disease by not wanting to know much about it. Perhaps your husband is like this?

  Hang in there. It sounds like if blasts were an issue that the doc would let you know.

  Patti

  May 12, 2007 at 4:32 am #18032
  Jack_dup1

  Member

  Jonelle,
  Again, my CBC from yesterday had the 1% blast in the blood listed on the form, the draw was taken one hour before I was given a copy and two hours before my BMB. It was a manual differential.
  How can Patti speak for most CBC’s
  Jack

  May 12, 2007 at 7:12 am #18033
  SandyB

  Member

  Patti:

  I notice that you always seem to have answers or advice, on just about anything. Where do you find information like what the majority of CBC forms show? I’d be interested in knowing what your sources are on so many of these subjects, as I also have a curious mind.

  Sandy

  May 12, 2007 at 8:11 am #18034
  patti

  Member

  I’m using a number of sources. We’ve talked about this with mom’s docs (because she had a huge quantity of blasts and I didn’t know any better in the beginning), my sister’s husband is a doctor who has told me this, he also had a daughter who died of leukemia and dealt with her docs at OHSU for four years. He said blasts were not listed on any pediatric counts he had ever seen there, and several people here have also stated that. The hospital mom was in never listed them out. How many sources do I need to state? Many of the conversations I had with docs occurred in the very beginning of mom’s dx because I’d come here and see the same thing Jonelle is seeing and then wonder. So, from multiple “medical” sources, it does not appear to be the “standard” to have blasts listed on CBC’s. That does not mean that I think you and Jack are lying or that they aren’t listed on yours. I’m simply telling someone, it’s not “usually” the standard. Jonelle was concerned about blast count and I was trying to put her mind at ease for the moment, that if her husband’s doctor was not concerned about blast count hopefully that meant everything was normal.

  For Pete’s sake, after researching and living this disease, AML and blood counts for two and a half years, I think I can share a few things with a pretty good amount of knowledge.

  I gotta tell ya, for all the crap folks like to pass around I keep wondering why I come back here….for some reason I thought what we learned with mom (not just natural stuff) would be a help to other folks. I’m beginning to wonder…..

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