I have a question about neutrophil percentages. My recent bloodwork had my neutrophil percentage at 7.0%. In December 2019 it was 14%. In August 2019 it was 21%. My ABS neutrophils are normal. My lymphocytes are at 85 and wbc is 39. Both, the lymphocytes and wbc have been going up slightly in the same time period. I began a walking regimen six weeks ago and of walking 6-8 miles per day, prior to my last blood work. I thought I read somewhere that exercise can effect (lower) the neutrophil count. Due to the neutrophil number coming down so quickly I am concerned. Can my walking be one of the factors of the neutrophil drop? Should I stop walking as I understand neutrophils are important for immune system function. How concerned should I be about the neutrophil drop? I have been on watch and wait for four years. Any experience or guidance would be appreciated. Thank you. Robert
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Rhythmauthor1
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Please calculate your absolute neutrophil counts over time and forget all about percentages. Because the total of white blood cell percentages must add up to 100%, when our lymphocyte count goes up (as is nearly always the case with CLL), then your percentage of neutrophils can go down, even if the absolute number of neutrophils goes up.
Remember, it's not the percentage of neutrophils that protect you from infection, but the absolute number!
Exercise can actually (temporarily) make your neutrophil count go up.
The adult normal cell count for neutrophils is about 1,500 to 8,000 or 1.5 to 8.0 neutrophils per microliters (mcL). The normal range based on differential readings are about 60 percent of neutrophils in total while blood cells.
Lymphocytes are normally about 30% of our white blood cells. Together neutrophils and lymphcoytes make up about 90% of all our white blood cells.
So if our normal lymphocyte count pre-cll is 5000 or so and jumps to 50000, so long as the neutrophils stay the same (the absolute number) their percentage will be driven way down by the jump in lymphocytes. That's why Neil says to pay attention to the absolute number.
Our cll and treatments we take for cll can drive the absolute number of neutrophils down. That's not good because neutrophils help us fight bacterial and fungal infections. Lymphocytes are more important with viral infections
Yes we could have plenty of neutrophils, within normal ranges, but CLL causes our lymphocytes to increase causing the ratio, or percentage of neutrophils to go down. Dropping percentage of neutrophils does not necessarily mean problems. You must know the absolute neutrophil count.
It may actually be shown on your blood test results as ANC. Or you may calculate them based on the percentage.
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