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Forum Name: Hematology Topics

Question: High WBC, Absolute Neuts and Monos... Leukemia??


 scorpioqte - Wed Jun 09, 2010 10:35 pm

I had a CBC test done and was hoping to get a possible answer as to what is going on with me. And to let you know I have seem a hematologist about 5 times over a 6 month time span & have gotten no answers. Below are the results of my last CBC test:

WBC 16.3 (H)
RBC 5.03

HEMOGLBN 13.1
HEMATOCRIT 40.2
MCV 80.0
MCH 26.2 (L)
MCHC 32.7 (L)
RDW 14.2

PLATELET CNT 336
MPV 9.2

SEGS 62.4
LYMPH 28.1
MONOS 6.9
EOS 1.9
BASO 0.7

ABS NEUT 10.2 (H)
ABS LYMPH 4.6
ABS MONO 1.1 (H)
ABS EOS 0.3
ABS BASO 0.1

What does this mean? I've never had a bone marrow test done & doesn't seem to think I need 1 done yet. He wants to monitor a few more months. I'm very concerned about this. ???
 Dr.M.Aroon kamath - Fri Jul 30, 2010 11:54 am

User avatar Hi,
Unfortunately you have not indicated the laboratory reference ranges for any of the values provided. Interpretation of these values without reference ranges is not advisable, as these ranges vary between laboratories. Also what is not clear is, whether these represent values on a single occasion or a sample of the pattern seen during the past 5-6 months.

As your main concern seems to be about leukemia, i will let you have some information about neutrophils and their relevance in this context.

Normally, not all the neutrophils in the blood 'circulate'. Some remain attached to the vessel walls(marginal pool). In some situations these 'marginated' neutrophils get released from their attachments and begin to circulate when dire need arises(acute stress,severe exercise,adminstration of epinephrine etc). This condition is known as Pseudoneutrophilia.

Segmented neutrophils (segs) are the mature neutrophils that have matured enough at release from the bone marrow and are functionally (phagocytosis) mature. Segmented neutrophils comprise 40-75 % of the peripheral leukocytes.They normally have 2 to 5 nuclear lobes.Normally, majority of the neutrophils circulating in the bloodstream are "segs".

The nucleus of less mature neutrophils on the other hand, is not segmented, but has a band or rod-like shape. Less mature neutrophils - ones that have recently been released 'in a hurry' from the bone marrow into the bloodstream - are known as "bands"(or stabs).Band cells are normally <10% of the total leukocyte count(mostly 3-5%). An increase in leukocytes (primarily neutrophils) used to be identified by a "left shift" in the ratio of immature to mature neutrophils in the "Arneth count" which is not in routinely performed these days.

Confusion arises at times due to the ways a differential count ("diff") is reported.Some laboratories report the band forms separately and others don't.

A leukocyte count above 25 to 30 x 109/L is termed a leukemoid reaction, which is the reaction of a healthy bone marrow to extreme stress, trauma, or infection.

Although the white blood cell count (WBCc) is typically thought of as being greatly increased in leukemia, the WBCc is in reality highly variable, and may range from severe leukopenia to extreme leukocytosis.The platelet counts are generally decreased in acute leukemias, but may be normal in chronic leukemias.The hematocrit and hemoglobin usually reveal a normocytic/normochromic picture.

For more about absolute monocytosis and lymphocytosis, click the following URLs.
viewtopic.php?f=58&t=45520&hilit=+monocytes
viewtopic.php?f=87&t=48247&hilit=+absolute+lymphocyte+count
viewtopic.php?f=40&t=40284&hilit=+absolute+lymphocyte+count

All you need to do at this stage is to heed to your doctor's advice, rather than to worry too much about this being leukemia.
Good luck!

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