help me understand what the significance of neutrophils,lymphocytes, and abs neutrophils is in relation to JAK 2

[milw532]

My platelet count is pretty steady at 567 and I am taking baby aspirin therapy only.. My monthly blood work showed an increase in abs neutrophils and neutrophils and a decrease in lymphocytes. My WBC also went up. I did make an appt. with the doctor but am quite disturbed--though I have read that this could result from stress--and I have a lot in my work! Do any of you have any info that will ease my mind or at least explain the significance/ Thanks!

[clubdino]

It is normal to have other abnormalities in your CBC when you have a MPN. Lymphocytes and neutrophils are just two different types of white blood cells. I usually have a high white blood cell count and high neutrophil count even though my diagnosis is ET...and this is going on 16 years for me. Having a high neutrophil count can automatically make your lymphocytes low depending on percentages. What is your WBC count, neutrophil count and lymphocyte count? Unless your WBC are over 16,000 I wouldn't worry too much.

[milw532 in reply to clubdino]

Thank you so much for your answering me. My WBC is 12.4, neutrophils is 81.3 and lymphocyte is 11.4. The abs neutrophils is 10. Does hematocrit also get affected? Mine is 52.9. Thank you again!

[clubdino in reply to milw532]

No problem...I know what it's like to be worried. Your white blood cell numbers don't appear too concerning...it's very similar to mine. But your hematocrit is rather high. Are you diagnosed with ET or PV? The hematocrit is not affected by stress or the white blood cells. But one of the things that can make your hematocrit falsely high is dehydration. Your hematocrit seems to point more in the direction of PV. Is your hematocrit always high?

[milw532 in reply to clubdino]

This blood testing was done as part of a physical and it was a fasting. The value in November which was NOT fasting was 49.7 and the time before was 51.4 (fasting) and 49.5 (NOT) The scale is 39-51 for normal.

[clubdino in reply to milw532]

Ahhh..you must be a male. Males have higher hematocrits than females. Every lab is different as far as reference ranges go for normal results...but I know for my lab anything over 45 is considered high that's why I thought your hematocrit may be too high. Either way you are on the verge of being high.

Your bloodwork results aren't anything to be very worried about right now but I think you are doing the right thing by making the doctors appt to discuss things. And it seems like you are doing a good job tracking your numbers. In the beginning stages of my ET I had high hematocrits and over the years my hematocrit fell into normal range. My white blood cells are almost always in the 10-12 range...every once in awhile they will pop into the normal range briefly. My platelets have never gone over 550k in 16 years. I'm on no treatment. I hope that makes you feel better.

[Applesnpears]

Have you been diagnosed with an MPN? Your haematologist should be telling you more than that you are JAK2 positive. Without a diagnosis it is difficult to interpret any changes in your blood results.

[hunter5582]

JAK2 (Janus Kinase 2) is one of the kinase systems in your body that regulations a host of functions. the JAK-STAT pathway impacts tumorigenesis and apoptosis. Neoplasms come out of the fact that the JAK2 mutation overactivates the JAK-STAT pathway, driving up hematopoiesis (production of blood cells). Essentially the "on-switch" is on too much. The overactivation of the JAK-STAT pathway also causes your body to make too many inflammatory cytokines. The increased cytokine load is thought to be related to many of the secondary MPN symptoms people experience.

The JAK2 gene mutation is complex and can result in ET-PV-MF and occasionally CML. How anyone of us is affected by the mutation is based on how the specifics of your own genetic profile play out. One aspect of this is the JAK2 mutant allele burden - the percentage of the JAK 2 gene that is mutated. Broadly speaking, people with less than 50% mutation will be more mildly effected. ET tend to have the lowest mutant allele burden, MF the highest, and PV in the middle.

You hematocrit does sound a bit high, which is a concern. Erythrocytosis (and leukocytosis) can actually be more of a risk factor than thrombocytosis. For PV treatment, keeping HCT below 45% (for males) is a critical treatment goal. Not sure what your diagnosis is, but I would definitely follow up on this.

FYI - many hematologists so rarely treat MPNs that they really don't have the KSAs to treat is optimally. My old hematologist actually missed it when my ET progressed to PV. Suggest you be sure to consult with a doc who really is a MPN expert. here is a list of patient-recommended MPN expert docs. mpnforum.com/list-hem/ . It is worth travelling to see one if you must do so.

All the best.

[Paul123456]

What is your HB and RBC? If your RBC is trending up you may be progressing to PV?

Your bloods are similar to how mine were. Dx ET but quickly changed to PV.

I’d suggest you see a specialist and might start thinking about drug intervention. Most Hems think WBC over the 11 - 15 range increases risk of thrombocytosis.

All I can say re drugs is that if I’d know at dx what I know now, I’d have started low dose Pegasys asap. Nothing is clinically proven but according to the expert Hems who are Pegasys bulls, starting low dose Pegasys asap seems the best bet in order to slow any progression. I’ve had no side effects and think Pegasys a great drug (famous last words!).

Best Paul