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Rising immature grans
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Rising immature grans

› Forums › General Melanoma Community › Rising immature grans

  • Post
    • July 8, 2017 at 11:39 pm
    Spl25
    Participant

      Stage 4 here with bone mets and liver mets. Ive had good success with Pembro over the past 10 months or so. While my blood numbers are overall quite good, my immature grans have increased to just over 1% of my total WBC count. This is a pretty unusual development in healthy persons, and I think, is a sign that there are some suppressive immune cells building around my existing cancer. Likely not good news, although nothing in the literature I've seen would indicate that its an early marker for progression. Has anyone had their immature grans increase under similar circumstances? How did things turn out? Has anyone seen any literature on immature grans and melanoma I may not have seen?

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        • July 9, 2017 at 12:21 am
        adrianc
        Participant

          Not much of a help here and please excuse my ignorance, but what are  immature grans?

            • July 9, 2017 at 12:56 am
            Spl25
            Participant

              Granulocytes (a type of WBC) which are undifferentiated (i.e. have not been primed to fight a specific type of foreign body)

              • July 9, 2017 at 1:15 am
              adrianc
              Participant

                Thank you for clarifying. Isn't increased WBC count indication that the immune system is  fighting infection/inflammation/cancer? So maybe those suppressive immune cells are not necessarily bad news. 

              • July 9, 2017 at 1:13 am
              Bubbles
              Participant

                I would talk to my doc.  Immature granulocytes are early neutrophils.  1% generally is not terribly elevated, in overwhelming sepsis for instance the percentage could be as high as 10-20%.  However, all percentages are relative to the other cellular proportion of the sample.  Bone mets can certainly influence what the marrow produces.  Eosinophils and a baseline NLR have been examined in regard to outcomes.   Here are some reports that talk about that:  http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/08/markers-for-response-to-immunotherapy.html  

                There are many things at play here that make looking at one isolated component from the CBC of limited value.  I would certainly see what my doc feels could be impacting your results, particularly if there have been changes.  Besides, they should review your labs with you anyway.

                I wish you my best. Celeste

                  • July 9, 2017 at 1:40 am
                  Spl25
                  Participant

                    Thanks so much Celeste —  my neutrophils overall are comparatively low (a good thing), but immature grans are closely related to those hated MDSCs (which are difficult to identify in the lab). I guess I'm hoping to find either some sort of life/dietary change that might help clear them out, or a clinical trial that would be a good match for someone succeptible to PD1 but with some myeloid miasma getting in the way (if progression were to happen). Stories from others who have had the same CBC profile are probably rare but a great bonus. I would hope that if the bone mets resolve, the immature grans production would resolve as well. My doctor has said that immature grans are not a good prognostic indicator, but there's not much we can do to address it and that other numbers look good. I think that's largely corrrect, but looking for other viewpoints or some data — I appreciate yours very much 🙂 

                  • September 14, 2018 at 5:03 pm
                  Canadian melanoma wife
                  Participant
                    Last week this granulocyte immature result was posted to my husband’s blood work. This week there is a reading for myeloid cells. Neither of these items have ever been posted in his blood work before. His treatment plan is the Ipi/Nivo combo that was started in mid March 2018 but he has not had an infusion for 9 weeks and isn’t scheduled to attempt to restart for another 5 weeks. He had several adverse reactions in August involving his skin, lungs and liver but with those magical steriods he seems to be in pretty good shape right now. The rollercoaster of ups and downs never fails to astound me. I’m just wondering if anything has come of this blood work for you? We live in Canada and we don’t see the oncologist unless we are on treatment and we have such a shortage of family doctors that even with a stage 4 cancer diagnosis it’s 4-5 weeks to get an appointment. We have a palliative care nurse who checks in but she doesn’t specialize in cancer so she doesn’t have an understanding of the readings involved. Please let me know if you have anything to report and I really genuinely hope you are doing well.
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