Increase in WBC

[Rhythmauthor1]

Hi everyone, my WBC rose from 39 to 51 in three months. My lymphocytes went from 85.0 to 88.7. My lymphocyte percentage is 45.2. Any ideas what can cause the wbc to jump like that? I have been on watch and wait since 2016. I have minor lymph node growth. I am not on treatment. My MD said instead of coming in every three months, to come back in two months to check the wbc count again. Accordjng to her I have the indolent variety of CLL, but am concerned. Would an increase in wbc be a cause to start treatment?

Any thoughts re possible causes?

Thank you,

Robert

[GMa27]

Not unusual for it to increase.

Do you know your markers?

[Rhythmauthor1]

Sorry, what is a marker?

[antonb in reply to Rhythmauthor1]

did you get a FISH test ( this test shows your chromosomes deletions and gives an idea of the prognosis ) ? is your Dr a CLL specialist or a general haemathologist ? Getting a specilst is usually a big difference

[AussieNeil Partner Administrator]

Hi Robert,

Blood test reports can be difficult to read and I'm fairly certain you have swapped the lymphocyte absolute and percentage figures. That's because the absolute lymphocyte count cannot exceed the WBC count, as it is just one of the five reported types of white blood cell counts which add up to your total WBC count. Also 88.7% × 51 = 45.2. See this post for more information: healthunlocked.com/cllsuppo...

Please check your figures and edit your post as needed via the 'More v' ... 'Edit' option below your post.

I suspect part of the increase in your WBC is due to CLL lymphocytes, with the rest of the change due to an increase in your absolute neutrophil count. How much did that change?

Note: Frustratingly, many blood test reports do not provide absolute counts. If that's the case, you need to multiple the white blood cell type percentage by the absolute WBC count to work out the absolute count.

Neil

[Rhythmauthor1 in reply to AussieNeil]

Hi Neil, thanks for the quick response. My neutophil percentage went from 7.0 to 8.8. My absolute neutrophil went from 2.73 to 4.5.

[AussieNeil Partner Administrator in reply to Rhythmauthor1]

If I'm guessing correctly, your lymphocyte count has increased from 33.15 (85% × 39) to 45.2. Lymphocyte counts bounce around considerably, so it could well come down next test. If not, your specialist should continue to monitor you more closely to see firstly if your lymphocyte count doubles in under 6 months. If that happens, she should be looking for further confirmation that you may need to start treatment. This post covers what is checked: healthunlocked.com/cllsuppo...

By the way, when GMa27 was asking about your markers, the one of most interest is your IGHV mutation status, which is much easier to have tested in the USA than elsewhere. IF you need treatment, you should only consider chemoimmunotherapy if you are IGHV mutated, which your may well be given you were told you have the indolent for of CLL. Thankfully you have ready access to non-chemo treatments in the USA, unlike the rest of the world.

Neil

[elkk in reply to AussieNeil]

Hi Neil, does the absolute neutrophil count increase with the ALC? is it of any significance when they are above the normal range?

[AussieNeil Partner Administrator in reply to elkk]

Lymphocyte and neutrophil production is independent, as they come from the lymphoid and myeloid stem cell lines respectively. When you have CLL, particularly as your lymphocyte count grows, the lymphocyte count is increasingly dominated by changes in your blood tumour load. At low lymphocyte counts, some infections could result in both counts increasing.

Neil

[elkk in reply to AussieNeil]

by low lymphocyte count do you mean lower than normal range? my ALC and ANC have both increased, just wondering if the neutrophil count being high has any real significance if there is no infection? Im easily confused sometimes🙈

thanks!

[AussieNeil Partner Administrator in reply to elkk]

You wouldn't have a lower than normal range lymphocyte count unless you were in treatment . With a very high lymphocyte count, I suspect that sometimes larger lymphocytes can be miscounted as neutrophils in automatic counting, so a manual count might be worthwhile.

Neil

[elkk in reply to AussieNeil]

thanks Neil, I probably wasn't very clear, yes my ALC is around 100 and the ANC is around 10 from memory, so the ANC can sometimes be miscounted? not sure what would be involved in a manual count? I am due for my next tests in a couple of weeks so will see what happens then , talk of treatment soon has been mentioned, thanks again

[AussieNeil Partner Administrator in reply to elkk]

Your specialist can request a manual count if concerned

[elkk in reply to AussieNeil]

thank you 😊

[Jm954 Administrator in reply to AussieNeil]

Neutrophils should never be counted as lymphs, either manually or by automated counters. The analysers are very sophisticated now and use size of the cells and the internal structure of the cell (nucleus size, shape and cytoplasmic granules) to determine the type of cell. Lasers are fired at individual cells as they pass through an orifice and the pattern of the light scatter is a unique signature.

The main difficulties can occasionally arise with large and small lymphocytes and sometimes monocytes, all of which can have similar internal structures and size.

In myelodysplasia the myeloid cells, and especially those with internal granules such as neutrohils, eosinophils and basophils, have very bizarre and abnormal structures which can be almost impossible to categorise.

Jackie

[Big_Dee]

Hello Rhythmauthor1

Looking good, looking good. My WBC went up 51K in one month, but I am still here.

[Big_knicker_blues]

Mine fluctuated a lot over 9 years of W&W. In the end it was the size of my lymph nodes that forced the decision to start treatment & my WBC count wasn’t particularly high at the time! Now 4.5 yrs post FCR chemo & all clear so far 😊 🤞. Good luck!