Rising WBC

[Frank Winn]

80 year old dx September 2006. 10 months since last blood transfusion. Counts Wednesday were: WBC 11.7 (up from previous week's 10.5), Hgb 10.5, Platelets 206. Take 1 Aranesp 200mG shot per week. Also taking 10mg of prednisone daily. Normally I would think that the WBC 11.7 means that I have an infection. Not the case. No fevers or chills. Normal range for my WBC has been from 3.0 to 3.5, sometimes much lower. At first the Dr. thought that the MDS may have progressed to leukemia. However could not find any blasts in the blood smear. Possibly Aranesp also affecting the WBC.

As a matter of interest, I am treated at the National Naval Medical Center, NCI/NNMC Clinic.

If anyone else has experienced this phenomenon I would appreciate hearing your details.

Warm regards to all,
Frank

[Bill F]

Hi Frank,

I haven't had any treatment for my MDS since my last Dacogen cycle which ended 3/2/07, except Exjade to reduce iron stores. In mid 2007 my WBC was
about 6, but over the last eleven months my WBC has risen from 8.9 to 12.5. It may or may not be of some significance - time will tell. My hematologist is more concerned with my enlarged spleen, weight loss, and low platelet count (36000). Everyone is different so it's hard to say how serious the elevated WBC really is, at least in the absence of an elevated blast count. By the way during the eleven months, I could not see a correlation between my WBC and the times I had an infection - go figure.

Bill F

[Marlene]

Steroids, like prednisone, can mask an infection. If it keeps up, can they do blood cultures, urine and stool samples to check for one. It may be worth asking.

From Rxlist.com under drug warnings. http://www.rxlist.com/deltasone-drug.htm

" Corticosteroids may mask some signs of infection, and new infections may appear during their use. Infections with any pathogen including viral, bacterial, fungal, protozoan or helminthic infections, in any location of the body, may be associated with the use of corticosteroids alone or in combination With other immunosuppressive agents that affect cellular immunity, humoral immunity, or neutrophil function."

[Frank Winn]

Thanks Marlene and Bill F for your appropriate and helpful comments. WBC Wednesday was 13.2 (Still going up). To verify that it is not caused by a worsening of the MDS, they have scheduled BMB for Monday.

Frank