Low neutrophils

[CountryHarbour]

Hey just got back latest blood work lymphocytes hasn't changed much but my neutrophils are pretty low ..is this common with CLL and what does it cause or mean ..I guess it's the reason I'm fatigued all the time I suppose

[AussieNeil Partner Administrator]

Neutropenia is a common side effect during all CLL treatments, but can also occur during watch and wait, due to bone marrow infiltration and rarely, due to an autoimmune complication of CLL. There's plenty of information on what to do in the section about neutropenia towards the end of this post: healthunlocked.com/cllsuppo...

I lived with fairly severe neutropenia for over a decade during watch and wait. Treatment improved my counts, but they are still lowish. Chronic neutropenia is not a trigger for starting treatment in any official CLL management guideline, but some specialists might suggest it, but I don't know on what basis.

With respect to your presumption about neutropenia being responsible for fatigue, given neutropenia means your immune system has to work harder to fight off infections, that might well be a factor, but fatigue is a common symptom with CLL in any case. Interestingly, I started struggling with fatigue in the years before I was diagnosed and it worsened when I entered the grade 3 and 4 neutropenia zones.

Do what you can to keep your risk of exposure to infections low and you might see an improvement.

Neil

[cajunjeff]

Hello CountryHarbour. I have had neutropenia as well. Just curious if you dont mind sharing, what number are you looking at and are you looking at percentages of neutrophils or an absolute number? It’s the absolute number that counts.

I wouldn’t think low neutrophils would cause fatigue, it just puts us at risk of infection. But as Neil correctly observes in his response, fatigue is an often complaint with cll and in the absence of low hemoglobin, it can be hard to pinpoint exactly what it is that causes fatigue in some cll patients.

One can have low neutrophils and do fine in some cases, but very low neutrophils can be quite serious. Thats why your actual numbers are important. My neutrophils dropped to dangerous levels when I was taking venetoclax and I was told to head straight to the emergency room if I had a fever. My neutrophils recovered to normal levels after I got off venetoclax.

[CountryHarbour in reply to cajunjeff]

Neutrophils auto. My number is 0.696 they use 0.190-0.480 as the normal rangeSegmented neutrophils my number is 0.190...they use 0.40-0.74 as normal range

A year ago lymph sum was 34330..not sure what it is now as the don't provide an ALC they just show individual lymph count

Maybe I'm just overreacting... frustrating though feeling tired

[Steffi50]

Hi CountryHarbour, it is common and mine tanked. There are loads of posts on this. I know neutropenia is not known for making you tired but I felt it when they were really low (well practically nil) until they started climbing again. Stay strong.

[Vizilo]

I’ve had CLL for almost 10 years and my neutrophils were almost non-existent most of that time. I was never fatigued in that time. Treatment with Acalabrutinib started about 3.5 years ago and my neutrophils are now in the normal range.

For a lot of us, neutropenia itself does not present symptoms. You learn of it through blood tests and it’s generally the culprit if you’re prone to frequent and sometimes nasty infections.

It would be interesting for us to know what your current position neutrophil count is.

Hope you’re feeling better!