NRBC# & NRBC%

[LouLou1976]

I am confused. Just had my hemo/oncology visit today. When I got home I looked at my blood work. It had two that I have never seen before.....

NRBC# 3.6 CH & NRBC% 30.7 CH is this a mistake? They had a hard time drawing my blood...could this have caused an inaccurate test?

[AussieNeil Administrator]

NRBC# is shorthand for Nucleated Red Blood Cell Count Number and NRBC% Nucleated Red Blood Cell Count Percentage. Red blood cells are created with a cell nucleus that is eliminated as the red blood cells mature, so if your specialist asked for a test of the number and proportion of immature red blood cells in your blood, then they were probably investigating whether you have some auto-immune complication which is affecting your red blood cell production, perhaps because you were becoming anaemic? Auto-immune complications aren't uncommon in CLL patients and this fits in with the ANA and RF tests you were given earlier.

From the lab Tests on Line website Chris referred you to earlier:

"Nucleated RBCs (NRBC, normoblasts): a very immature form of RBCs seen when there is a severe demand for RBCs to be released by the bone marrow or marrow involvement by fibrosis or tumor; may be seen in severe anemia, myelofibrosis, thalassemia, miliary tuberculosis, cancers that involve the bone marrow (like CLL - Neil), and in chronic low oxygen levels (hypoxemia)."

I can't see how problems drawing your blood would have any influence on that test outcome (the red blood cell nuclei are either there or they aren't), though it can influence other results, like the level of LDH. Also, with automated testing, you can get confusing results when your blood picture is different than normal and blood cell sizes confuse the automated counting process, including differentiating between NRBCs and white blood cells.

I really hope that someone with more understanding than I have can help you. It's a pity that your specialist didn't mention why this test was done; you really do need to talk with them about the tests you are being given. Is there any chance of contacting them and asking about this? It seems to me that your specialist isn't all that communicative.

I guess you can take some reassurance that nothing was specifically mentioned about your red blood cell production during your consult...

Neil

[LouLou1976 in reply to AussieNeil]

Thank you Neil. Yeah, I guess I can take comfort in the fact she said nothing of these two counts on my lab report.......still trying to convince myself that I don't have CLL and it is all a mistake.... when I know my body is at war....I feel it all the time...too weird, I say to myself all the time....I don't feel bad, I don't feel nauseated....I am not tired. I think it keeps me motivated. This site has been really good for me....I see posts that make me feel that I am not alone in all of this. Thanks to all for your openness.