Low WBC and low Neutrophils but no symmptoms
 

Hello, Over the past 9 months my WBC has been dropping.. Over the last month my neutrohils are dropping as well. My hematologist is having me get a bone marrow biopsy. My question is has anyone seen this with absolutely no symptoms at all? I am a 32 year old female and I am very healthy. I am a fulltime nursing student and mother of 2 young boys. I have not experienced and symptoms, no sickness, no fatigue, no infections.. nothing. My recent count today was WBS at 1.8 and nuetrphils at 0.8. With these numbers I feel like I should be very ill or showing some sort of signs of cancer or disease. Any incite? Thank you for your time.

Welcome to this forum. I had no symptoms right up until I had a stem cell transplant. I was golfing and walking the six mile golf course until a week before the transplant. If you are diagnosed with MDS or anything else, feel fortunate that you are catching it early while feeling well. It might not be anything serious, but take it seriously until you find out. What has your doctor suggested?

My Dr. Really hasn't said much. She just said stay positive a d wait till we have a bone marrow biobsy. She has never even mentioned MDS, with MDS arnt your RBC low as well? All my other lab values have been perfect. It's just weird cause I workout a lot ,lift weights, eat healthy and haven't caught any of the nasty sickness that has been in my house for a solid month. And I can't seem to find much on just low WBC and low neutrophils. I almost feel like the BMB is a little over the top right now. I just went in for routine bloodwork for a physical and all this happened.

Biopsy not transplant

The BMB is not "over the top". I have had 16 BMBs. They can rule out a lot and it is nice to have things ruled out. If they do find something, it is a real advantage for you to catch it early. Hopefully everything is fine. My RBCs were normal when I was diagnosed. My WBCs were 4.7 and neutrophils at 2.1 (both normal). My platelets were low at 48.

Hi. My husband's situation is somewhat similar to yours. He went to donate blood and was turned away due to low hematocrit--somewhere around 32. His initial CBC showed something like RBC of 3.4, Platelets of 130, and WBC of 2.0 (neutrophils at around 1000). Much testing resulted in various diagnoses: iron deficiency anemia, suspected early aplastic anemia, monoclonal gammopathy of undetermined significance (very mild), and hypogammaglobulenemia (also relatively mild). What's the root problem? His doctors certainly don't seem to know, but it is hard to imagine that all of these symptoms are unrelated.

At any rate, the reason I think his situation is somewhat similar to yours is that after taking oral iron supplements regularly, plus a multivitamin supplement, his RBC now hovers around 4.0 and his storage ferritin is in normal range, and his platelets have remained steady between 120 and 135. His WBC count also stays usually in the 1.8-2.1 range, and his neutrophils are usually between 700 and 1000. So, very mildly low RBC and platelets paired with moderately low WBC and neutrophils. His bone marrow biopsy showed something like 25% cellularity, which was low for a man in his late 40s. As for health, he was getting sick a lot when first diagnosed--with some weird sinus infections (they would migrate to his eyes, etc.), other respiratory ailments, and mild skin infections like boils. But for all practical purposes--work, parenting, recreation, etc.--he's been fine for the past two or three years, with not even an unusual number of colds.

His hematologist told him that it isn't always a question of his many neutrophils you have but instead how good they are at their jobs. And I'm sure it makes a difference if they are able to summon reinforcements when the going gets tough, though through all his return check-up testing none of my husbands' counts have ever gone back up more than a smidgen higher than they were at diagnosis.

Good luck and try to find ways to remain calm and upbeat while your doctor gathers more information. And do make sure they check your nutritional status carefully. Low copper, for example (or excessive zinc intake), can result in lowered neutrophil counts.

Barbara

Thanks for the information and your replys. I am still very hopeful since all my other values are totally normal. The waiting game is intense tho for sure

If you haven't already, find out what your vitamin D, B12, folate, copper, zinc and iron are. I know a couple of people who had low a chronic low WBC which was corrected with D3/K2 and bio-available B vitamins, specifically B12 and Folate.

Their D was low and the B12 was a low normal.

It's worth checking out.

I am having a similar experience. My WBCs have been low for many years (low 3s and recently dropped to 2.8). I also had low RBC and platelets for the first time during routine physical (slightly low) and when I went to the hematologist recently, he re-ran the bloodwork. RBCs and platelets were back to lower end of normal but WBCs still low.

He also ran a whole lot of other blood tests that all came back normal as well as an abdominal ultrasound.

I am having a bone marrow biopsy on Thursday. He said it was my call. We could watch and wait or we could move forward with BMB. I am 55 yo and adopted so I opted to have the BMB in hopes of catching things early if there is a problem.

I am really healthy, normal energy, very good diet, normal weight.

Worried but hope that everything is good on Thursday.

Terre

The difference between low 3's and 2.8 seems pretty small to me -- 10-12% or so, and WBCs fluctuate a fair amount even in healthy individuals based on time of day, so that may not represent a trend of any sort. If your blood counts have been stable for many years (and you don't get persistent infections), that may just represent your baseline and nothing to be concerned about.

What was the abdominal ultrasound for ? I didn't think those were used to diagnose blood cell counts ..

===== The hematologist was looking to see if my spleen was enlarged. It was normal.

Thank you for taking a look...

Terre

Good luck and please let me know what they say. It sounds like our stories are similar.

Please do the same! My BMB is today!

All the best,

Terre

Biopsy
 

FYI, this is an article on neutropenia treatment

http://www.bloodjournal.org/content/...o-checked=true


However, in patients with a long history of mild isolated neutropenia, the results of bone marrow aspiration and biopsy are nearly uniformly inconclusive, deeming the procedures probably unnecessary.

That should be comforting for people who are about to undergo a biopsy or even those who decide to forego one.

Great article made me feel much better. Thank you so much for this.

I had chronic idiopathic (of unknown origin) neutropenia and lymphopenia for many years before MDS finally became evident. It's possible to live a very normal life with this condition provided you know how to avoid infections.

Hi, how did your BMB go? I had mine today. Not too bad just wish I got instant results

Hi Magsoh19 -- I was wondering when yours was scheduled. Did you have conscious sedation?

Overall, I would say it went well. There was a bit of miscommunication between the hematologist's office and the hospital. I had specifically requested and had been told I would have "conscious sedation". When they wheeled me back, they informed me that I would only get a Xanax and Lidocaine. I don't have a high tolerance for pain so that was a "no-go" and they ended up adding Versed. I remember everything but I didn't experience a lot of pain. I was pretty scared and I am glad it is over. I get the results on Friday afternoon... How long do you have to wait?

All the best, Terre

I have had 16 BMBs. I usually get 3-4 results ("Genetrails AML/MDS Gene Mutation Panel", "Hematopathology", "Cytogenetics Bone Marrow Chromosome Analysis") that are spread out for about 2 weeks after the BMBs. Now, post transplant I get a couple additional tests.

Oh good I'm glad it went well. Please keep me posted on your findings. I was actually given iv propofol so I was out and don't remeber it. I feel pretty overall and just sore.

Thank you Marlene,

I went through my bloodwork. Here is what I have:

WBC 3.3 (range 4.0-10.6)
Neutrophils # 1.8 (range 1.8-7.0)
Vitamin D, Hydroxy 37 (range 30-100)
B-12 936 (range 193-936)
Folate 25.6 (range 5.6-56.3)

In addition to CBC and Chem Panel, hematologist ran ANA Screen, C-Reactive Protein, HIV, Neutrophil Antibody, Rheumatoid Factor. All of "extra tests" were normal.

I am going for BMB results on Friday. Would it be a good idea to ask that copper, zinc and iron be checked too?

I think I need more Vitamin D so I may check on the D3/K2. It seems like it couldn't hurt to go on the bio-available B vitamins since they are water soluble and any excess would be excreted through urination.

Thoughts?

Thanks, Terre

Thank you, Bailie - this is really good information.

Terre

Well did you get results? I am starting to have extreme anxiety waiting for mine :(

Low WBC
 

This is how I started out wasn't feeling very well had a blood check WBC low next thing I know I was of to have a BMBT, they found that my bone marrow was normal so I carried on with life having blood test done every year then the worse thing happen low counts all round of to have another BMBT You can live with MDS and not even know it what I will be doing with low white cells is making sure you are keeping up with personal hygiene, and no white sugar, Sugar eats your white cells.
DX RCMD now on fortnightly blood transfusions after Vidaza stopped working

Magsoh19 -- Good news... I had my appointment and they said that my bone marrow is normal. They want to recheck my bloodwork in 3 months and again in 6 months with follow-up with the doctor. I pray you have the same result!

I think I understand a "little bit" more about all of this but it seems very complicated and fluid. I am grateful that I have been checked out and that my doctor wants to continue to monitor me.

I am checking every day to see if you have gotten your results, too.

This is a very knowledgeable and supportive group.

Terre