what does this mean?

[MarianneS]

husband 79 diagnosed mds raeb2 8/2013 started vidaza immed upon diagnosis. Has had five cycles completed with good results & no complications. Today had weekly cbc before started sixth cycle and wbc under normal. Does this indicate start of relapse?

[Neil Cuadra]

Marianne,

You won't really know until further CBCs are done. Any single CBC can give misleading or at least inconclusive results. That's because counts can fluctuate from time to time and be affected by temporary factors. If your husband's WBC changed only slightly then it may just be the normal variation from one CBC test to the next. If it dropped by a large number it could be the result of a poorly done test.

It could also indicate a real problem and a setback in treatment, which is what you're worried about, but you can't conclude that from a single CBC result.

You could wait for the next cycle's routine CBC, but you could also ask for a repeat of the lab test now so you'll have peace of mind sooner. If the results are low again, it's time to meet with the doctor and talk about what it means and what can be done about it.

[MarianneS]

Thanks for info. Test is going to be done again on Monday a.m. Will let you know.

[MarianneS]

just realized hubby was on an antibiotic for seventeen days for respiratory
infection. Will antibiotic have an effect on wbc and neut?

[Neil Cuadra]

Marianne,

Your white blood cell count goes up when you have an infection. That's the white cell army amassing to battle the infection. Neutrophils are a percentage of white cells so they go up too.

When you are taking an antibiotic and the infection lessens, the elevated white count drops. The bottom line is that you can't use the WBC and neutrophil counts from CBCs (or from a white cell differential test) to judge the ongoing condition of a bone marrow failure disease.

Once the infection and your husband's antibiotics have cleared his system, the CBC lab results will be more useful and can be compared against other CBCs.

It can be a little confusing for us patients to keep in mind everything that affects blood counts, but the doctors understand how to interpret them and they also rely on other tests for more precise information.

[MarianneS]

thanks for the explanation...makes things a little clearer to me. Will keep you posted.

[MarianneS]

went for vidaza infusion today, blood test shows everything normal except wbc...went down further...now at 2.04. Asked infusion nurse to contact doctor which she did. She gave him blood results and he replied to continue with vidaza (sixth cycle). Nothing further to update except now blood test results indicate "neutropenia".