Does your blood test show "Blast Cells"? Let's talk about this!

Sometimes you may see something called "Blast Cells" in your blood report. It's normal to feel a little nervous when you see it. Even hearing the word "blast" can be a little scary. But before you get nervous, let's talk briefly about what exactly these blast cells are, why they are important to our bodies, and what happens if they increase in number?

What are blast cells? Is that all you need to know?

Yes, it's important to know this. Simply put, blast cells are a type of immature, or not fully developed, young cell in our body. These are the cells that give rise to the different types of cells in our body. But if you get a lab report that says "blasts," it usually means immature blood cells. Because hematologists and oncologists use things like the number of blast cells in your blood to diagnose certain blood-related diseases, such as acute leukemia.

If you have abnormally shaped blast cells or a high number of them in your blood, it could be a sign of some blood cancer. That's why you should be concerned about this.

So, what is the difference between blood stem cells and blast cells?

This may seem a bit complicated, but it's actually quite simple. Think about it, these are both important stages in the development of our cells.

Blood stem cells are like mother cells that give rise to all other types of cells.

Blast cells develop from these stem cells. They are also called "progenitor" or "precursor" cells. That is, they are a "pre" stage before a fully mature cell develops. Unlike a stem cell, a blast cell is already determined to become a specific type of cell. It's like going to university and studying general subjects first, then focusing on a specific field.

What are the benefits of blast cells to our body?

A blast cell is just an early stage of blood cell formation. Your body is constantly making new blood cells (along with blast cells) to replace old cells. This process of blood formation is called hematopoiesis . This happens most of the time in your bone marrow .

Inside your bone marrow, there is a common stem cell called a "hematopoietic stem cell" (HSC). This gives rise to two main types of blast cells:

• Myeloblast: This type of blast cell gives rise to red blood cells, white blood cells (for example, granulocytes, neutrophils, basophils, and eosinophils), and platelets .
• Lymphoblast: This type of blast cell gives rise to lymphocytes, a type of white blood cell.

Fully developed, mature blood cells leave the bone marrow and travel through your bloodstream. However, the blast cells that are still developing belong in your bone marrow, not in your blood. That's why a lab report showing blast cells in your blood can be a problem.

Why are these blast cells increasing? Is something wrong?

If a lab report shows that you have a high number of blast cells in your bone marrow or blood, it could be a sign of a blood cancer, such as leukemia. Especially if the cells look abnormal when viewed under a microscope. Normally, only 5% of the total blood cells in your bone marrow should be blast cells. It is not good to have any blast cells in your blood at all.

There are several main reasons why blast cells increase:

• Acute myeloid leukemia (AML)
• Myelodysplastic syndrome (MDS)
• Chronic myeloid leukemia (CML)
• Acute lymphoblastic leukemia (ALL)
• Some non-cancerous conditions and treatments

Let's look at each of these in a little more detail.

Let's learn about Acute Myeloid Leukemia (AML)

Most of the time, when doctors talk about blast cells, they are referring to acute myeloid leukemia (AML) . AML is a very aggressive type of cancer that spreads very quickly. Therefore, it is very important to diagnose the disease and start treatment as soon as possible. Testing for these blast cells is an important way to detect the disease early.

In AML, abnormal blast cells accumulate in your bone marrow and leak out into your blood. Most of these are a type of cell called myeloblasts. These are ready to become white blood cells (granulocytes) before they become cancer cells.

Because these blast cells are immature and abnormal, they do not do any useful work for the body. Instead, they take up so much space in the bone marrow that they stop your body from making the new, healthy blood cells it needs. Without properly functioning, mature blood cells, your body cannot function normally.

If you have 20% or more blast cells in your bone marrow or blood, it is a sign of AML.

What is Myelodysplastic Syndrome (MDS)?

Myelodysplastic syndrome (MDS) is also a type of blood cancer. What happens here is that blast cells do not develop into normal blood cells. Often, these blast cells die before they can mature properly. Even though there are too many blast cells, when there are too few mature cells that can do their job, problems such as anemia can occur. Also, you may get frequent infections (due to low white blood cells) and bleed or bruise easily (due to low platelets).

If you have between 5% and 20% blast cells in your bone marrow, it is a sign of a condition called `MDS.` About 30% of people with `MDS` will eventually develop `AML.`

Let's also look at Chronic Myeloid Leukemia (CML).

Chronic myeloid leukemia (CML) is a long-term (chronic) blood cancer. It also causes an increase in the number of blast cells in the bone marrow or blood. Doctors classify the severity of the condition based on your blast cell level:

• Chronic Phase CML: Less than 10% of the cells in your blood or bone marrow are blast cells.
• Accelerated Phase CML: Between 10% and 19% of the cells in your blood are blast cells.
• Blast Phase CML (blast crisis): More than 20% of the cells in your blood are blast cells. This is similar to AML.

What is Acute Lymphoblastic Leukemia (ALL)?

Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children. In ALL, the bone marrow produces abnormal (cancerous) cells called lymphoblasts. These abnormal cells divide rapidly and make many copies of themselves. This makes it harder for the bone marrow to make the normal cells your body needs.

In ALL, at least 20% of the blood cells in your bone marrow are blast cells. Most people diagnosed with the disease (about 90%) also have blast cells in their blood.

Can blast cells increase due to other causes other than cancer?

Yes, this is very important. Don't assume that cancer is the result of a lab report showing high blast cells. Some non-cancerous conditions and causes can also cause a temporary increase in blast cells. Examples include:

• Severe infections: If your body develops a serious illness, such as a severe infection (sepsis), blast cells can enter the blood.
• Granulocyte-colony stimulating factor (G-CSF) treatment: Blast cells may still be seen in the blood after receiving a type of injection called G-CSF. These injections stimulate your bone marrow to produce more white blood cells to protect you from infections. These may be needed if you are receiving chemotherapy or if you have a low white blood cell count (neutropenia).
• Stem cell transplants: If you have had a stem cell transplant as a treatment for a medical condition, you may also have an increase in blast cells. Stem cell transplants may be necessary for conditions such as blood disorders, cancer, or autoimmune diseases in which your body cannot make normal blood cells.

But the important thing is that, unlike the blast cells associated with cancer, the blast cells seen in these cases usually look healthy under a microscope. They can also develop into normal blood cells. Over time, this number decreases.

How do you accurately check the level of blast cells? What are those tests?

There are several tests that show blast cell levels:

• Peripheral blood smear (PBS): This test shows the presence of blast cells in your blood. In a PBS, a pathologist looks at a sample of your blood under a microscope to see if there are too many blast cells or if they look abnormal.
• Bone marrow tests: Lab tests performed after a bone marrow biopsy or aspiration can identify blast cells in the bone marrow. These may include tests such as flow cytometry, immunohistochemistry, or fluorescence in situ hybridization (FISH) to look for genetic changes in the cells .
• You may also need to have a complete blood count (CBC) with differential to check your red and white blood cell and platelet counts, as the number of healthy blood cells can decrease as the number of blast cells increases.

Doctors consider a variety of test results and factors before diagnosing a condition like leukemia. They don't make big decisions based on just one test.

Finally, a few things to remember

The most important thing to remember when you see the word "blasts" on your lab report is not to panic. It's true that having blast cells in your blood can be a sign of a serious illness. But that varies depending on your health condition. Sometimes, an increase in blast cells is temporary. The number will go down over time. Other times, it can be a sign of something more serious, like acute leukemia. Only your doctor can explain exactly what your results mean for your health. So, if you have any questions, don't hesitate to ask your doctor.

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