White blood cells keep decreasing

[TheTopBanana]

Hello, the latest blood test showed that my father’s white blood cells keep decreasing. This worries me alot, alot. He is going to do additional tests Hb, trombocyts and additional analysis of the white blood cells. When I google I think this might mean that the cancer is in the bone marrow. Thankful for any input (especially calming inputs).

[pjoshea13]

Hi,

Do you have his NLR (neutrophil/lymphocyte ratio)? This might be more significant than the total. Neutrophils & lymphocytes are types of white blood cell. If you have counts, you can calculate the ratio. Lower is better.

What meds, if any, is he currently on? How is his general health?

Best, -Patrick

[TheTopBanana in reply to pjoshea13]

He is going to do additional tests for NLR, so I’ll get back to you, thank you!!

[TheTopBanana in reply to pjoshea13]

No meds, general health is good!

[LearnAll]

Decrease in white blood cells does not necessarily mean bone marrow invasion. It depends on how low the WBC has fallen and at what level other blood cells such as Platelets (thrombocytes) and Red cells are . All these different cells have to be looked at before getting alarmed about bone marrow. In general, low White cells is good sign as it indicates low inflammation.

All three cell lines needs to be falling together in case of bone marrow invasion. If PSA and ALP are in normal range, chances of bone marrow invasion are very low.

[TheTopBanana in reply to LearnAll]

Thank you! He is going to test thrombocytes etc. Do you mind me asking you again when those results are in?

[LearnAll in reply to TheTopBanana]

sure,

[TheTopBanana in reply to LearnAll]

Thank you!!!The results from today:

Kreatinin (enz)57 mikromol/L <100 mikromol/L

Pt-eGFR(Krea)relativ

>90 mL/min/1.7 >60 mL/min/1.7

X-Lkc, poly

1,9 x10(9)/L

X-Lkc, mono

1,3 x10(9)/L

X-Leukocyter

3,2 x10(9)/L

P--Natrium 140 mmol/L 137 - 145 mmol/L

P--Kalium

4,1 mmol/L 3,5 - 4,6 mmol/L

B--Leukocyter

3,5 x10(9)/L 3,5 - 8,8 x10(9)/L

B--Erytrocyter

4,0 x10(12)/L *4,2 - 5,7 x10(12)/L

B--Hemoglobin (Hb)132 g/L *134 - 170 g/L

B--EVF 038 *0,39 - 0,50

B--MCV 32 fL 82 - 98 fL

Erc(B)--MCHVisa i kumulativ lista33 pg 27 - 33 pg

B--Trombocyter 208 x10(9)/L 145 - 348 x10(9)/L

[Justfor_ in reply to TheTopBanana]

RDC of 4,0 is at the border of anemia. The various lab I am using, place the lower normal reading at 4,2 (like yours), but also a bit higher at 4,4 or even 4,5. On the other hand, Sloan Kettering CC in the USA place it at 3,95 -5,54. It is the norm for men with PCa to be almost anemic.

[TheTopBanana in reply to Justfor_]

How come?

[Justfor_ in reply to TheTopBanana]

I read a paper that divides anemia into 4 or 5 subclasses. Iron deficiency is the most common but not the only one. Chronic inflammation from a number of sources including cancer is next on the list.

[LearnAll in reply to TheTopBanana]

It is somewhat hard for me to clearly understand the numbers as they are expressed in different way than here in USA. But let me try. Creatinine and e GFR numbers indicating normal kidney function.

Red cells 4 million and Hb 13.2 indicate normal values. He does not have Anemia. Only Hb below 12 can be of some concern. Hb 13.2 is good sign.

White cells 3.2 is low but still good and a lower WBC in absence of low red cells is in fact a good sign. I do not think 3.5 should be a concern as it indicates lower inflammation and lack of active infection. White cells above 10 is usually a matter of concern.

Platelets(thrombocytes) 208 is on lower side of normal range and , remember a lower thrombocyte number is good for men with prostate cancer. WHY ? Because too many thrombocytes stick to the surface of cancer cells and hide them from NK Cells and Macrophages thus keeping cancer cells alive.

Sodium 140 and Potassium 4.1 are very good numbers...so there is no electrolyte imbalance.

Important: I do not believe he has Any sign of bone marrow invasion in this blood test report.

In my opinion, all these numbers are good and I do not notice any cause to worry. Just my opinion. .let his doctor say the final word.

[TheTopBanana in reply to LearnAll]

Very helpful Thank you very much!!

[Tall_Allen]

If it were in the bone marrow, it would have shown up in scans he has done. Deal with what you know instead of letting the gremlins in your head go wild.

[TheTopBanana in reply to Tall_Allen]

Thank you. Wise words, the gremlins in my head was definitely having a pre corona all night-party the day I wrote this.

[Zetabow]

My scans showed it had got into the bone marrow (both femurs), with various drugs and blood transfusions they managed to turn things around. It certainly doesn't mean a death sentence, it just requires good care from the doctors and a little luck. I got a call yesterday it seems my bone marrow is failing again, they will start with blood transfusions today.

[SeosamhM in reply to Zetabow]

Sending good thoughts, Zetabow!

[TheTopBanana in reply to Zetabow]

Thank you for sharing! So thankful for this forum because of the experiences. Wishing you all the best with the blood transfusions!

[Hidden]

My WBC has bounced around for at least the last six years. From a low of 2.3 to a high of 4.8. It slowly trends down and slowly trends up. When it hit 2.7 I asked a well known medical oncologist why my white count was so low. He replied, " You have plenty of white bloods cells, stop worrying." So I did.

[TheTopBanana in reply to Hidden]

Thank you, that is very calming to hear!