BMB end of cycle 3 of O+V, "neutrophil bands increased from 2% to 16%" Is this a good or bad thing?

[SurfSurf]

BMB end of cycle 3 of O+V, "neutrophil bands increased from 2% to 16%" Is this a good or bad?

[Poodle2]

I think it would be helpful to know the actual number rather than a percentage. They should be above 2.

[SurfSurf in reply to Poodle2]

Hi Poodle2, the report doesn't give an actual number, I looked having learned about this from AussieNeil. Is an increase in neutrophil bands a good or bad thing after almost 3 months of O+V is the question.

[Poodle2 in reply to SurfSurf]

Do you have the absolute white cell count? It can be calculated. Increase can be a good thing if you were neutropenic and you need to get into a safe range. However, an increase can also signify an infection. If your neutrophils were 0.2 and now they are 3.4, that's a very needed increase. If they were 3.5 and they are now 15, that could mean an infection...so it isn't that straightforward.

Note - I have just read the other responses. It would seem that the increase is good as you were neutropenic and took GCSF injections.

[neurodervish]

Neutrophils help the immune system fight infections. They normally make up 55 to 70 percent of white blood cells. For us CLL patients, low neutrophils is usually the problem (called neutropenia). So an increase is generally considered a good thing. Do you have a total neutrophil count (non percentage, but absolute number)?

[SurfSurf in reply to neurodervish]

The nos I quoted for neutrophil bands were from BMB Aug 23. My latest CBC was Sept 10– ANC was .6 and I got the neupogen shot. Dr tells me the O+V are beating up my neutrophils. Thank you for the information. Am a very anxious “first timer.”

[AussieNeil Partner Administrator in reply to SurfSurf]

Glad we were all able to work out that you have been neutropenic and that the increase in neutrophil bands is showing that you are responding to your G-CSF (Filgrastim, Neupogen, Neulasta, Zarzio, etc) shots. Neutrophils use our blood stream to migrate from the bone marrow to our tissues, where they work to protect us from infection. They are our first defenders when bacteria, fungi and viruses get past our protective barriers against infection. When your bone marrow stops making neutrophils, the blood neutrophil count drops towards zero in a matter of hours to days. It takes 10 days for your bone marrow production line to produce new ones, e.g. from the stimulus of a Neupogen injection. If production has just slowed, then you get the banded (immature) neutrophils appearing earlier, which might be marked upon you lab test report as a 'left shift' en.wikipedia.org/wiki/Left_...

While you did mention your neutropenia in this previous post healthunlocked.com/cllsuppo... this is where a bit more information in your bio can really help us help you. When we are new to living with CLL, and/or the complexity is overwhelming, we don't necessarily know what background information is important to include in our posts. I note you are keeping your bio up to date, but noting your were neutropenic and had had some Neupogen shots, helps everyone appreciate what's going on and what they might expect if they have the same treatment (This link enables you to edit your bio: healthunlocked.com/profile/... )

The important blood counts to watch are as follows, so you might like to add in your results for each cycle:

- Haemoglobin (anaemia - how much energy giving oxygen your body is receiving )

- Platelets (prevent bleeding. There's more bruising as they drop low)

- Neutrophils (our first defenders against infection)

- Lymphocytes (A measure of how well we are responding to treatment)

Because neutrophil counts can drop rapidly and you've already had stage 3 neutropenia (an absolute neutrophil count (ANC) between 0.5 and 1.0), it's very important to be extra vigilant against infection and to be on the lookout for febrile neutropenia, where you need prompt IV antibiotics. The end of this post has a section on managing neutropenia

healthunlocked.com/cllsuppo...

Good to know your bone marrow is responsive to keeping you safe from infection!

Neil

[SurfSurf in reply to AussieNeil]

Thank you Neil for the expanded explanation, will update my profile now. Appreciate everyone’s responses, this community is amazing.

[neurodervish]

PS- Sorry, I just looked up "neutrophil bands" and learned that they are "Less mature neutrophils - those that have recently been released from the bone marrow into the bloodstream." Do they grow up to become full fledged neutrophils? Hopefully someone better educated will weigh in. 😛

[SurfSurf in reply to neurodervish]

Got it, let’s see if someone in our community weighs in, trying to avoid writing to the Dr 😁

[SofiaDeo]

I didn't answer this question earlier because it's impossible to just pull a single sentence, or part of a lab report, out from the entirety and attach a meaning.

Now that you have said you have taken a Neupogen injection, and that your doc has said your neuts are taking a beating so they gave you it, I can speculate that the increase in bands is likely due to the drug injection stimulating new neutrophils. Our bodies can make neutrophils in response to a number of stimuli. In your case, I would guess it's from the shot. If someone reported high fever, shaking, & chills, an increase could also result as a response to fighting off an infection. A single lab change often is meaningless/difficult to interpret without more information. Glad you explained a bit more, hopefully this eases your mind a bit!

[SurfSurf in reply to SofiaDeo]

Thank you SofiaDeo— I had a approx 4 neupogen shots and probably one before the Aug 23 BMB so makes sense. Thank you!