Can someone explain white cell breakdown?

[patti]

Hi all,

I have searched the web and can’t get a clear understanding of what I’m looking at on mom’s blood test results today. Her blood work shows her ANC’s at 300. I know that’s low. What I don’t understand is that her lymphocytes are increasing. Today they were 59 and of particular interest to the doctor. Can someone tell me what normal amounts of lymphocytes are and what this might mean? I have noticed the lymphocytes have steadily increased. I think they started out at 30 a year ago when diagnosed. Any help would be appreciated.

Thanks

patti

[Neil]

Hi Patti,
It is dificult to cover all of the info on lymphocytes and neutrophils without including the rest of the leukocytes.
Suggest you click on the following link.
http://web2.airmail.net/uthman/blood_cells.html
It will take you to Blood Cells and the CBC. A great site that is written in easy to understand language and should have the answers to your questions

[patti]

Thanks, neil. I’ll take a look. Got a call from blood bank that mom’s type and cross did’t go through because the person did not double check her numbers and one of them was incorrect. Have to take her in tomorrow for another type and cross before friday’s transfusion. This is so frustrating. I wouldn’t care if I lived ten minutes away. But we live an hour away. Ugh.

Thanks again, Neil.

Patti

[patti]

Neil,

I read the whole thing on blood cells. He doesn’t say much about lymphocytes. My understanding was that if lymphyocytes increase it means a person has leukemia. Is that correct? I am expecting at mom’s next appt. they’re going to recommend another BMB. Any help you can give would be appreciated.

Patti

[Neil]

Hi Patti,
As a rule an increase in WBC is an indication a patient is transforming to leukemia. Can also be an indication of an infection.
Your MIL has RAEB-t. Transformation to leukemia is what the DX anticipated —at some future point. Most docs will try to take steps to delay transformation as long as possible and maintain her present status.
Have the docs discussed how they would lower her blasts? Or how they would attempt to keep blasts from getting into the peripheral blood?
These are efforts they would be focusing on and would tend to delay transformation.
Age and health aside from MDS have a an influence on how fast the disease will progress.

[Vasilios2]

Patti, the number for lympocytes is a % of total WBC. Thus it can be 90% and within Normal limits. As Neil correctly said an increase of WBC count over the normal limits may indicate problems
Hope this helps

[patti]

Neil,

Okay, so the number I really need to be looking at is the total WBC? There is no doubt something is going on. Mom has a yeast infection on her skin all over her body. Her doctor did tell me she would transform to leukemia before this is all done. Mom has not done anything to increase the blasts in her blood because she does not believe chemo is a good option. Although, she may change her mind in light of all that’s happened this week. Honestly, I think if she did the Vidaza that she would not survive it. She just doesn’t have enough ANC’s to handle infection. Her best ANC day is 500. Usually stays around 400.

Thanks again for your help. I greatly appreciate it and have a better understanding now.

patti

[uno grasshopper]

Hi Patti:

There are basically 5 types of white cells circulating in the blood that are counted in a routine CBC–neutrophils, lymphocyctes, eosinophils, monocytes, and basophils. All 5 combined represent your total WBC. They are commonly counted by percentage in the blood stream–i.e. normal counts would be approx. 65% neutrophils, 25% lymphocytes, 5% monocytes, 3% eosinophils, and 2% basophils. When you add up all those percentage figures, you come up with a total of 100%. So, if one group of cells were to go down in percentage, then another group of cells goes up in percentage. But they always total 100 regardless of your total WBC. They should always total 100% even if the percentages are all screwed up. For instance aplastic anemia patients very commonly have low neutrophil counts and very high lymphocyte counts. At one point I had zero neutrophils, 1% plasmazoids, and 99% lymphocytes (totalling 100%), BUT my “total” white count was very low at .5 even with a high lymphocyte count of 99%. (But technically since my total WBC was so low, the “absolute” lymphocyte count was also quite low). So no, a high lymphocyte “percentage” does “not” necessarily mean leukemia. You can have a high lymphocyte percentage w/a low total white blood count if the other white cells are decreasing. With leukemia generally the total WBC would increase, not just the lymphocyctes. But there are actually forms of leukemia wherein the white count is very low. Infections, whether bacterial, viral, fungal, etc, also affect the white cell percentages since bacterial infections usu result in increased neuts, and viral infections sometimes results in decreased neuts, etc. There are various things that can affect the percentages.

What it looks like to me is that your mom’s total neutrophil count is decreasing, and that’s why it looks like her lymphocytes are increasing. Remember they always total 100 “percent”, so if there are more lymphs, then there are less of something else. But, you didn’t mention what her other cell percentages are or have been or what her total WBC is. With an ANC of 300 and a lymph percent of 59, I’m guessing your mom’s total WBC might be in the 1s? Hard to say for sure w/o knowing the rest of the percentages.

Hope this helps,

Marla

[patti]

Marla,

Thank you! I understand now! Bless you guys. All of you! Yes, mom’s WBC’s are around 1300. I couldn’t figure out why the doctor was concerned about the lymphs on tuesday. I still don’t know why, but at least I understand a little more now. When I look at her numbers tomorrow I will sift through and check out the 100% thing and see if anything else is moving around or if it’s just this yeast on her body causing problems.

Thanks again, Marla. What a great explanation.

Patti

[Jack_dup1]

Neil,
I could have gone all day without reading that increased WBC indicates Leukemia transformation. My whites have increases every month 2.5 years. The only good thing is my total count percentages stay in accecpable ranges. I have had no infections. This month was the first drop 36.6 to 33.0. My Neutrophils are 81%, Lymphs 7%, Monos 9,4%. I feel great, other than tiring easily.
I know what your saying is true, seeing it sometimes is un-nerving.
Jack

[Dennis]

Increasing WBC is a good thing if you’re still below the normal range, isn’t it?

[Jack_dup1]

Dennis,
Oh yeah!!! Keep it up.
Jack

[Neil]

It is amazing how low WBC can go without having any problems. Am usually in the 1.1-1.4 range.
Have had 4 colds in the last 8 1/2 years and no infections. ANC appears to be a vital component. My doc looks at it and comments every time we get together. He is after me to put on weight. Feels I will have a better time fighting an infection when it happens. Not if but when.

[patti]

Mom had a transfusion today so I took the five hours to review her blood counts from the past many months. Her whites as a whole range from 1.3 to 1.7. Mostly around 1.3 though. Her ANC never goes above 500. Neil, I had never considered the “when” she gets an infection, only the “if.” I just figured if we could keep her healthy we’d avoid infection. I guess not forever, huh?

I’m glad you put it that way Neil or I would have continued to deceive myself. Oh well……

patti

[Neil]

Hi Patti,
Those existiing WBC evidently are working.
Would also make sure she gets her Vitamins (as long as her doc agrees). A multi Vitamin, B Complex and Vitamin C have worked well for me so far. Have tried other supplements for as long as a year without any benefit and keep looking for that “silver bullet”. No luck so far for me. Believe the problem is an abnormal chromosome. Dont think black sesame seeds can fix a 20q-.

[Author]

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