Laboratory and Diagnostic Procedures CBC White Blood Cells (WBC)

Result

Normal Values

Interpretation

0.6

Adults: 5-10x109/L Children: 6.2-17.0x109/L 0.20-0.40

Lymphoblasts quickly grows and replace WBC in the bone marrow and prevent from being made. The bone marrow produces immature cells that develop into leukemic white blood cells called lymphoblasts. These abnormal cells are unable to function properly, and they can build up and crowd out healthy cells.

Lymphocytes

0.58

Red Blood Cells (RBC)

2.21

Male: 4.5-6.0x109/L Female: 4.0-5.5x109/L

Due to increased production of WBC it results in decreased production of RBC and resulting into anemia which is one of the primary symptoms of ALL.

Hemoglobin

61

Male: 120-170g/L Female: 110-150g/L

Changes in this level are due to changes in the Red Blood Cell count and occur for the same reason resulting to decrease tissue perfusion and leading to pale skin. Decreased in Hematocrit count is due to decreased Red Blood Cell and resulting into anemia. Decreased in Segmenters is usually due to decreased WBC count and occur for the same reason. Not remarkable

Hematocrit

0.19

Male: 0.40-0.54 Female: 0.37-0.47 0.50-0.70

Segmenters

0.25

Monocytes APC Platelet count

0.07

0-0.07 150-450x109/L

28

Because of decreased production of Platelet, frequent bleeding results as manifested by bruises.

Laboratory and Diagnostic Procedures

Result

Normal Values

Interpretation

Lumbar Puncture (Spinal Tap) Appearance Clear and colorless Cloudy CSF, may indicate that there is an infection or a buildup of white blood cells or protein. Not remarkable Decreased in Glucose level in the CSF may indicate Leukemia spreading to meninges. Not remarkable

CSF pressure Glucose

50-180 mmH2O 40-85 mg/dL

Protein

15-50 mg/dL

Leukocytes (WBC)

Adults and Children: 0-5/microL Newborn: 30/microL

Decreased in White blood Cell count is due to over proliferation of Lymphoblast and suppressed the production of other blood cells and compromised the immune system. This is due to over proliferation of immature Lymphocyte (Blast) in the bone marrow. Not remarkable Not remarkable

Lymphocytes

60-70%

Monocytes Neutrophils

30-50% none

Laboratory and Diagnostic Procedures Bone Marrow Aspiration and Biopsy Blasts Promyelocytes Myelocytes Metamyelocytes Neutrophils Eosinophils Basophils Lymphocytes Plasma Cells Monocytes Pronormoblasts Normoblasts Other: M:E Ratio

Result

Normal Values

Interpretation

0-3 2-8 5-20 13-32 7-30 0-4 0-1 3-17 0-2 0-5 1-8 7-32

Due to over production of Lymphocyte (Blasts) they suppressed the normal production of other blood cells. Very few recognizable neutrophils circulate in ALL, and even in the bone marrow red and white blood cell elements may be hard to find. The predominant cell, both in blood and in the marrow, is a blast (Presence of over 30% blast cells indicates an Acute

Lymphocytic/Lymphoblastic Leukemia). Anemia is always pronounced, with very low platelet count. A marrow aspirate shows the marrow spicules to be almost totally replaced by blast.

3-4

Laboratory and Diagnostic Procedures ALT (SGPT)

Result

Normal Values

Interpretation

22.0

7 -56

There is no remarkable result in both ALT (SGPT) and AST (SGOT). Results are both in normal range which implies that there is no excessive released in Aspartate Aminotransferase (found in heart, kidney, brain, muscle

AST (SGOT)

24.3

5-40

and liver) and Alanine Aminotransferase (largely found in liver). Liver detoxify medicine normally (as the patient is in still in chemotherapy).