Answer: It is very good that your HCL has been in remission for 15 years. These blood counts may be nothing to be concerned about, especially if you are well and the red cell and platelet counts are normal. However, small changes in the blood count can be the first sign of the disease returning and it is important to identify this early before you become affected by it. In relation to your recent counts, it is important to know not just the total white blood cell (WBC) count but also the numbers of the different cell types – neutrophils, lymphocytes and monocytes in particular. If the levels of neutrophils and/or monocytes have fallen to low levels, that would be more significant and may indicate that your HCL is returning slowly.  If this is the case, then of course it can be retreated very easily. Given your good results from your previous treatment, the HCL would be expected to respond well again. Many people require treatment more than once over their lifetime, but survival is not affected by this. However, it is possible that the white blood cell count may have dropped a little for other reasons (for example, a viral infection) or it is just random (normally these counts do fluctuate).

Posted April 2014 in the category: When to Treat or Re-Treat