I'm a little scared with my cbc

[19ashley89]

I had some blood work done it shows low wbc at 3.4, rbc at 4.24 and abnormal mpv 11.6 most worrisome results is NEUTROPHILS 34.7 %LYMPHOCYTES 49.5 What could this mean? I got to the doctor tomorrow but I've just been so nervous. I also have a few enlarged lymph nodes in my neck that have been there for several months and a positive ANA

[AussieNeil Partner Administrator]

Hi Ashley,

Do you have a diagnosis of CLL or SLL? Your low WBC only makes sense if you are under treatment. Per this recent post, healthunlocked.com/cllsuppo... percentages should be ignored if you have CLL/SLL, but irrespective, it is the absolute counts that matter.

Your absolute counts can be determined if they aren't already stated in your blood test report, by multiplying the percentage by the total WBC count. So your lymphocyte count is 3.4 x 49.% or 1.7 which is in the normal range. Importantly, your neutrophil count is 3.4 x 34.7% or 1.2. That means that you have stage 2 neutropenia, so you are at increased risk of infection. If you are in treatment, you need to discuss what to do to reduce your infection risk with your specialist.

Neil

[19ashley89 in reply to AussieNeil]

Hi no I haven't received a diagnosis but I am going to see a hematologist. So just concerned

[AussieNeil Partner Administrator in reply to 19ashley89]

If your neutropenia is persistent, particularly if some of your other blood counts are low, it's possible that you might have the much more rare SLL presentation of CLL/SLL. In that case, you may not have enough CLL cells in your blood for a diagnosis via the standard immunophenotype flow cytometry blood test to determine if you have a leukaemia/lymphoma. In cases like this, you'd need flow cytometry testing done on a biopsy of a swollen node or from a bone marrow biopsy for a diagnosis.

Neil

[Newdawn Administrator]

I note you’ve returned a positive ANA result Ashley. In most cases, a positive ANA test indicates that your immune system has launched a misdirected attack on your own tissue…in other words, an autoimmune reaction. However, some people have positive ANA tests even when they're healthy.

You’ve also mentioned a platelet condition in other posts which I assume is a reduced platelet count. These are matters for your haematologist but it made me wonder if there’s a link and a cause here.

(Thrombocytopenia refers to low levels of platelets. Neutropenia refers to the low levels of neutrophils which you seem to have presently). As Neil says, this requires you to be extra careful about infections.

I’m glad you’re seeing a haematologist for advice because you need a definitive diagnosis for whatever is causing these errant blood results and enlarged nodes. If you receive a CLL/SLL diagnosis, this site will be pleased to give you further advice and support.

Best wishes,

Newdawn

[LeoPa]

Your lymphocytes cannot be higher than your white blood cells. Percentages are not important. Could you write down the absolute values to avoid misunderstanding? White blood cells, lymphocytes, neutrophils.

[19ashley89 in reply to LeoPa]

I wasn't given the absolute values just the percentages

[LeoPa in reply to 19ashley89]

I see. Can you ask for them during your next visit?

[SofiaDeo in reply to 19ashley89]

Is this something you were told over the phone, and possibly mishearing? It seems you are in the US, and all the labs here I have ever seen always report absolute numbers to the docs. Percentages may or may not be posted. This is a standardized reporting format required by JCAHO as well as CLIA. If I remember correctly, and statutes haven't changed, any lab accepting Federal funds has to follow CLIA. I think JCO is optional, although many insurance companies require JCAHO accreditation.

[AussieNeil Partner Administrator in reply to 19ashley89]

LeoPa and SofiaDeo , I replied to Ashey with my calculated absolute blood counts from the figures she provided in my first reply to her. Ashley, I assumed your percentage figures and WBC, which you said was low were correct. That's because the percentages add up to around what I'd expect, given the typical allowance for other white blood cell types, but do check.

Sofia, over the years I have seen lots of US members provide blood test reports with just WBC differential percentages along with only the absolute WBC. It's sadly too common an occurrence here and on other CLL Support sites to see requests for how to calculate absolute counts, so I really hope CBC reports are changing.

On a related matter, I've personally had a few doctors I've seen get unnecessarily concerned at my lymphocyte and neutrophil percentages. In my experience, doctors commonly quickly glance at the percentages, which work fine for other than blood cancer patients, which after all, are not common. This goes back to the manual way the white blood cell differential was originally calculated and reported, when the laboratory techician counted 100 white blood cells and assigned each cell counted into the relevant white blood cell type category. Some of the white cells even get their names from the staining agent used to differentiate them; eosin, baso, neutro.

Neil

[19ashley89]

Just an update I went to a new doctor today not so good news. They found a mass in my right breast and a few enlarged nodes in my neck that I have to go have a sonogram done on. Other than that, I am being referred to a rheumatologist as well as waiting on referral for a hematologist. This didn't help with my anxiety.

[Newdawn Administrator in reply to 19ashley89]

Just take it one step, one day at a time Ashley until all the pieces fit together and the right treatment plan can be found.

Best wishes,

Newdawn

[19ashley89]

Thank you I'm trying to stay positive. My doctor was worried because heart rate was up and my bp was 88/66