low wbc

[sdrake]

My dad has been on Vidaza since February with a brief delay in June or July due to low wbc. His ANC was around 500. Since resuming the Vidaza his rbc has been around 3.5 and his hemoglobin in the 10.5 – 11.7 range which is great for him (Dad has CMML). His platelets have been staying in the low normal range – I think the lowest was 90. He just finished his last shot of Vidaza for this round and his ANC was 840. His WBC always goes down before coming back up to barely high enough right before he is ready for the next round of shots. It seems pretty low now and that worries me. His oncologist put him on antibiotics when his ANC got to 500 before. With cold and flu season coming on I am concerned for him. Do others on Vidaza have trouble with low ANC? Thanks

[sarah]

Yesterday my husbands ANC was .14, I thought this was low. I am somewhat confused by the way this is on CBC.Are we using different measurements?

[Harold]

ANC is the combined number of segs (mature neutrophils) and bands (almost mature neutrophils). So if the white blood cells are 60% segs and 6% bands (and 34% other), and the total WBC is 10,000, the ANC = (60%+6%) x 10,000 or 6,600. By convention this is reported as 6.60 but some labs may report it as 6600. So an ANC of .14 is 140 neutrophils and an ANC of 540 is .540.

[sdrake]

Dad’s wbc was 1.3, his seg neutrophils 61, and his band 4. I guess this figures out to be an ANC of 845. Dad’s oncology nurse told us to multiply the wbc by 10 and then multiply that by the neutrophils + bands. I think I have that right. It seems different labs use different measurements. It is all too confusing.

[Neil]

Hi sdrake,
Had my session with my doc this AM. Counts have been declining slightly for a few months.
He is waiting for my neuts to get to 500 and will then put me on GCSF. He feels I can fight off the sinus infections, bronchitis and pneumonia above 500. Too much risk when it drops below that point.
Also had a discussion on cell cloning. All 3 lines are cloning, but it has not involved many more cells. There seems to be enough normal cells that are not cloning. They seem to be sufficient to handle the infection fighting job at present.
Based on the progression of the count decline I projected it will be sometime around March maybe as long as May before we have to adjust our plans. Hope Revlimid will be approved by then

[sdrake]

I’m pretty new to all these terms – what is GCSF? Is Vidaza not an option for you? Revlimid is approved for 5q tx dependent patients now – is that right? From what I have read, it seems that Revlimid is a promising drug, but do people who aren’t 5q respond as well? I’m not sure if Dad has chromosome abnomalities or not. All I know is they tested for the Phildelphia chromosome to make sure he didn’t have CML. He didn’t so the diagnosis was CMML.

[Neil]

GCST is granulocyte colony stimulating factor. Such as Neupogen or Filgrastim.
Vidaza is not likely to work on me. It works on about 18% of patients. My doc had 6 patients on it. Had 6 non-responders. Think it works best on those with RAEB.
Revlimid has not been approved by the FDA.
It has been used on patients in clinical trials.
Those with 5q have had very good responses. Those without 5q have also had good responses. Depends upon what restrictions the FDA imposes when the approval comes through. Generally there are ways to obtain an approved drug if the patient has enough positives to get it on an exception or if the FDA opens the door wider..

[campbell]

My husbands WBC is 2.7 and SEGS/NEUT 54.7/ LYMPHS 27.8 / MONO 11.9 / EOS 4.5 / BASOS 1.1… can someone with some experience explain to me the meaning of these numbers…. this is a terrible disease. I had a kidney Transplant about 2.5 yrs ago and 5 mos ago I had both my native kidneys removed………… I am on so much meds that I sometimes have trouble thinking . As you can see I need all the help I can get.

[patti]

Hi Campbell,

The 2.7 WBC is a total white cell count of 2700. The percentages you have listed are of the different types of white cells that the 2700 is made up of. For example: 54.7% of 2700 is 1476.9. So he has 1476.9 ANC’s.

One time a gal on this board gave me a great, easy to understand explanation of white cells. She said that the percentages of each of the different white cells will always add up to 100%. So if ANC’s go up then some other portion of the white cells will go down because the percentage will always equal 100%. I found that very helpful.

Neutrophils are the infection fighting white cells (sometimes listed as ANC or absolute neutrophils). Lymphocytes, monocytes, eosophils and basophils are each a type of white cell also. I can’t give you much explanation of what each of those do. I know we focus mainly on the ANC’s because those are the infection fighting cells.

Hope this was helpful.

Patti

[krishananth]

My dad too felt he had become weak and hence required a transfusion . when his CBP was taken his platelets showed 22K, WBC – 3800 and HG- 5.3

His earlier CBP taken more than 1.5 months earlier showed a platelet of 20K, WC – 3100 and Hg – 5.4

Wanted to know if the increase in WBC is a cause of concern?

Cheers
Sandhya

[campbell]

Thanks Patty for the quick reply… I now understand better what that means. You know you read all the medical info. and it takes someone to tell you in plain english.

[patti]

Sandhya,

I do not know if you need to be concerned about your dad’s increased WBC. I’ll share with you our experience and you can take it for what’s it’s worth (which is just one experience).

Mom has had a number of times where her WBC has gone from 1100 (her normal) to 4800. During those times she has obvious symptoms of AML (which is now her “official” diagnosis). She doubles her efforts on juicing, cleansing, etc. and her WBC comes back down to 1100 range within a week or two. Her doctor’s opinion is that during these times of increased WBC her body is trying to kick into “active” AML (for lack of a better word) and somehow she manages to push it back down. But really, the only way to know if the increased WBC is an issue is either long term tracking of his counts (which is how we figured out what was happening to mom) or a BMB to show where his blast count is at. It’s also possible to have an increase in WBC if someone is fighting an infection. There are so many variables I don’t think it’s possible to conclude one thing or another from that small amount of an increase. I would talk to his doctor and see what he says. I know that because we didn’t want a BMB done on mom we had to take the long term approach to seeing what the increases in her WBC meant.

All the best,

patti

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