Sludge Blood

Audrey's question - Can someone fill me in on the significance of smudge cells. The last blood test at the GP showed "15 smudge cells per 100 wbc" - is 'quirkily' simple.
Cells that are fragile - like CLL cells but not only CLL cells - will break apart during the process used to make smears or to identify cells by a machine. They make a "smudge". Increases in smudge cells usually goes along with increasing fragile cells. CLL cells appear to be the most fragile - some people have up to 50% of the cells smudged. This probably doesn't occur int he body - only in the artifical processing environment of the lab but it remains an interesting phenomenon - to us wierdos in the lab at any rate. Typically, there are 1-2 smudged cells in everyone's smear.
 

Suppose you have 15 marbles and you put them into a cup of water. When you shake the cup, the marbles don't move very much because they don't have much room. You cam "make" them move more easily if you 1) put the 15 marbles into a quart container 2) take out 8 of the marbles, leaving only 7 in the cup.

If you have 250,000 white cells and you are dehydrated, you are not going to get an easy flow of blood through the small vessels. But if you have 250,000 cells and you are well hydrated, then the flow will be much easier.