Low White Cells

After 9 years on W&W, I started chemotherapy for CLL last September. I had 3 rounds of Bendamustine & Rituximab followed each time by hospitalisation for neutropaenic fever. I was so ill and very low white cells, my consultant gave me a rest of 8 weeks and then I had a long acting GCSF followed by one round of Rituximab only, one month ago. My blood results today show that my white cells are persistently low WBC 1.9, Neutrophils 0.4 and Lymphocytes 0.9. All the other counts are well within normal. Today I have started a 5 day course of GCSF to boost the white cells. But there is one result I do not understand - Red cell distribution width (RDW) of 15.0. Does anyone know what this means? My doc didn't mention it so I assume it's nothing to worry about.

In spite of the low whites, I am feeling well & have a good energy level with no cll symptoms. Great relief but still have to be vigilant about picking up any infections.

Any thoughts, anybody?


8 Replies

  • Jeff, here's a definition of RDW from a note in a blood count tracking spreadsheet provided by Chaya Venkat that I'm currently updating:

    "(RDW): Red blood cell Distribution Width. Red blood cells can come in different sizes. RDW looks at the range of these sizes in a blood sample. If anaemia is suspected, based on other blood counts, RDW test results are often used together with MCV* results to figure out what the cause of the anaemia might be.

    *(MCV): "Mean Corpuscular Volume" measures the average volume (size) of individual red blood cells. A low MCV means that the cells are smaller than normal. This is usually caused by an iron deficiency or chronic disease."

    I wouldn't worry about your RDW result as it is just at the top of the normal range and it would be something that your specialist would monitor. I'd expect that it could drift back from the upper limit as your bone marrow recovers from the last chemo, or perhaps that's a normal level for you. About 5% of healthy people have test results outside the 'normal' range and their results are normal for them.

    Great to hear your good results from chemo. Don't forget to also be careful about your diet while your neutrophils are low:



  • Thanks Neil. That is very reassuring and affirms my confidence in my doctors. Yes, I am being careful about my diet, I,m looking forward to the day I can safely eat some of my favourite foods! But not yet!

    I wish all cllers a good outcome.


  • Good news that you are feeling better Jeff. Summer is on its way.

    My best wishes


  • Thank you whitecell. It's great to feel better and be back in the garden and on the golf course! A lovely day yesterday with a promise of summer to come.

    With my best wishes to you.

  • Best wishes for a speedy recovery from chemo and a good long remission. It is my understanding that it is the job of the chemo to destroy white blood cells; in a perfect world that would just be mutated B lymphocytes but not there yet. So healthy cells get taken out with the cancer cells.

  • Thanks for your reply and best wishes. The chemo has certainly done it's job - I've just got to be vigilant about picking up any infections.

    Here's to a long remission!

    Best wishes to you too.

  • Good to hear you are feeling well, agree with Neil this could be normal for you. Good luck going forward.

  • Thanks for your comment. I have just checked my previous results and it does look as if my RDW has a tendency to be on the high end of normal. So, nothing to worry about.

    Best wishes.

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