CBC Question

I was wondering if you could help me figure out what my CBC with Differential results might indicate.

My WBC's have been elevated for at least 2 years.  I get tested about every 6 months, and they range from 11.1 to 15.0

My LAP score is 174

My B-12 was 279 but I have been taking B-12 supplements for a few months, (3,000mcg/day) and it has increased to 800.

My absolute neutrophils are 8051

All other results seem to be fine.

I don't think any of these scores are extremely high, but I am not sure if I should be worried.

Thank you

[Fernando Roque, MD]

Hi.  An elevated white blood cell count (called leukocytosis) without any accompanying symptoms can have various causes.  The most common type of asymptomatic leukocytosis is what is termed as "reactive", which means that the increase in white cell count is a reaction to some ongoing infection or inflammation.  Other causes include obesity, physical or emotional stress, and intake of certain medications like steroids, some asthma medications (beta-agonists), and lithium (a drug used for manic-depressive disorder).  

A persistent leukocytosis may also be a symptom of a blood disorder like chronic leukemia.  The LAP (leukocyte alkaline phosphatase) score is used to differentiate leukocytosis which is due to chronic leukemia with those due to inflammation/ infection.  Reactive leukocytosis usually has a normal or elevated LAP score, while chronic leukemia tends to have a low LAP score.  Your LAP score of 174 is elevated (normal value: 25-130) so your leukocytosis is most probably not due to leukemia, but to a benign condition.