What are Smudge Cells? Do they indicate CLL?

Posted by reneebarber77 @reneebarber77, Aug 12, 2022

If I have smudge cells in my blood and do not have high white cells could that be a consideration for CLL?

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Smudge cells are exactly that—cells that were destroyed during the collection or preparing of the blood smear, creating a smudge look on the glass slide. They’re remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure. They are indicative of weakened cells as normal cells have stronger, defined membranes.
Smudge cells, also called basket cells, are most often associated with abnormally fragile lymphocytes in disorders such as chronic lymphocytic leukemia (CLL). However, they can also be seen in viral infections as documented here in an article from pubmed.gov https://pubmed.ncbi.nlm.nih.gov/33598404/

I also found this site from epainassist.com that gives a good, less technical explanation about Smudge cells https://www.epainassist.com/blood-diseases/smudge-cells

Smudge cells aren’t unique to CLL, though they are seen more commonly and in higher numbers in CLL.

Is this a recent discovery for you? Have you discussed this finding with a hematolgist?

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@loribmt

Smudge cells are exactly that—cells that were destroyed during the collection or preparing of the blood smear, creating a smudge look on the glass slide. They’re remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure. They are indicative of weakened cells as normal cells have stronger, defined membranes.
Smudge cells, also called basket cells, are most often associated with abnormally fragile lymphocytes in disorders such as chronic lymphocytic leukemia (CLL). However, they can also be seen in viral infections as documented here in an article from pubmed.gov https://pubmed.ncbi.nlm.nih.gov/33598404/

I also found this site from epainassist.com that gives a good, less technical explanation about Smudge cells https://www.epainassist.com/blood-diseases/smudge-cells

Smudge cells aren’t unique to CLL, though they are seen more commonly and in higher numbers in CLL.

Is this a recent discovery for you? Have you discussed this finding with a hematolgist?

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This is new to me, I have to go for another blood test in one week. If they still exist, then I will be referred to the oncologist

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@reneebarber77

This is new to me, I have to go for another blood test in one week. If they still exist, then I will be referred to the oncologist

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This will feel like a long week for you with the anxiety of waiting for the results of this second blood test. I can empathize with that feeling!
If it does reveal continued defective cells with the potential for Chronic Lymphatic Leukemia, the most common form of that blood cancer can be very slow to progress. Often patients can go years without any changes or treatment. A hematologist/oncologist will be able to evaluate your blood results and guide your from there. However, this next blood test may show everything returned to normal and all the concern was for nothing.

Is this something that was discovered in a routine physical or are you having symptoms?

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This is a routine exam, having headaches but have some other symptoms.

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@reneebarber77

This is a routine exam, having headaches but have some other symptoms.

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I’d really like to follow along on your discovery. Will you keep me posted along the way?

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@reneebarber77

This is new to me, I have to go for another blood test in one week. If they still exist, then I will be referred to the oncologist

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Hi Renee, just following up. Did you have another blood test? Any updates?

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@loribmt

Smudge cells are exactly that—cells that were destroyed during the collection or preparing of the blood smear, creating a smudge look on the glass slide. They’re remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure. They are indicative of weakened cells as normal cells have stronger, defined membranes.
Smudge cells, also called basket cells, are most often associated with abnormally fragile lymphocytes in disorders such as chronic lymphocytic leukemia (CLL). However, they can also be seen in viral infections as documented here in an article from pubmed.gov https://pubmed.ncbi.nlm.nih.gov/33598404/

I also found this site from epainassist.com that gives a good, less technical explanation about Smudge cells https://www.epainassist.com/blood-diseases/smudge-cells

Smudge cells aren’t unique to CLL, though they are seen more commonly and in higher numbers in CLL.

Is this a recent discovery for you? Have you discussed this finding with a hematolgist?

Jump to this post

My moms cbc has been abnormal for about a year and has been back and forth with her PCP. I told her she needed to go see a hematologist, but her PCP said that she should wait because they’re going to give her antibiotics and take care of the situation so now her last CBC, which was the ninth of this much came back with moderate smudge cells before it was few smudge cells but it’s changed to moderate I told her to do a peripheral blood smear and the doctor that I work for recommended. She have a whole bunch of tests done and her PCP didn’t do those but now they’re going to move forward with doing the test that my doctor told me to have her recommend to her PCP. I’m scared that it could be leukemia but she feels like it’s nothing right now her leukocytes is at a 14.7. It’s gone up from a 13.2

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@vero210

My moms cbc has been abnormal for about a year and has been back and forth with her PCP. I told her she needed to go see a hematologist, but her PCP said that she should wait because they’re going to give her antibiotics and take care of the situation so now her last CBC, which was the ninth of this much came back with moderate smudge cells before it was few smudge cells but it’s changed to moderate I told her to do a peripheral blood smear and the doctor that I work for recommended. She have a whole bunch of tests done and her PCP didn’t do those but now they’re going to move forward with doing the test that my doctor told me to have her recommend to her PCP. I’m scared that it could be leukemia but she feels like it’s nothing right now her leukocytes is at a 14.7. It’s gone up from a 13.2

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Hi @vero210, mom’s are notorious for ‘I’m fine, nothing’s wrong’… She’s lucky to have an attentive daughter who is proactive for her mom’s health. ☺️

If your mom is dealing with smudge cells, I think you’re already aware that this could be an indication of Chronic Lymphocytic Leukemia (CLL), though there are also some other occurrences where cells can be fragile and ‘smear’ when being tested.

I know the word leukemia puts fear in any heart. But CLL is generally very slow to develop and often patients don’t require any treatment for years. So take a deep breath and we’ll wait to find out what your mom’s bloodwork shows. I had a very serious and aggressive form of leukemia and now in a durable remission. (My daughter was in the same position of ‘fearing the worst’). I know the anxiety of bloodwork but it’s also beneficial to find things out early if there is an issue. And often, what we imagine is much worse than reality. 🙃

Is your mom having the peripheral blood smear done soon? Let me know what you find out, ok?

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