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Absolute neutrophils

Can somebody educate me on what this exactly is and how it affects treatment, or how treatment affects this?  

Sorry for the dumb question...still trying to get everything figured out what you guys are talking about.

Thank you,

Jill
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Avatar universal
Thanks for your time and information. This all pretty much goes with my search and my ideas. My last WBC was @ 17.0 and the ranges show 4.0 - 10.5. When I had my bout with pneumonia back in Oct. '09 my WBC was as high as 34.0, if I remember correctly, I will have to look that up. Of course the doctor had me on an expensive high dose of antibiotic and I was close to be admitted to the hospital. After I got better I was told to take some probiotics for a while to replace the good bacteria that was lost due to the antibotics, there is good and bad bacteria. When my WBC remained high the doctor was concerned about other issues and sent me for a CT scan, after which I was referred to a cancer doctor. After a year and a half of appointments and also more bloodwork and CTs, that doctor released me saying he felt that everything was ok, but said that he "would leave his door open for me". Through all the testing I had you would think that one of the tests should have been for Hepatitis, but no. HCV was discovered by the Red Cross when I donated blood. So, you can see that this has all been a very frustrating experience, a journey which may never end, more things might come up later!
Thanks again for your time, take care, Mike

"Change is the essential process of all existence." (Spock)
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Avatar universal
Your situation is so unusual that it made me curious to read up a bit.  I found this one short article and it concurs with what frijole said, that your white counts going up when you have no spleen might indicate there's an infection being fought and your white cells are getting busy with it.

http://www.ncbi.nlm.nih.gov/pubmed/8034344

Just something to think about or talk to your doctor about.  If infection is an issue and treatment brings your white counts down and makes you even more vulnerable that way then perhaps it might be worth talking to your doctor about putting you on an antibiotic while on treatment?  Or to be prepared to?  Kind of a shot in the dark on my part but that is what my docs did with me when my white counts dropped. At first a relatively benign antibiotic and then when specific components of my white counts dropped, they pulled out the big guns and put me on heavy duty antibiotics and I stayed on them until those white counts came back up.  Just tossing that out there.

The other thing is I'd be sure to have a treatment doc who's very experienced at treating people with Hepatitis C and knows his stuff.  Your situation sounds like it's a bit of a challenge and a less experienced doctor might not have the confidence to proceed with certain approaches if they get nervous.  A more experienced doctor would have a better idea of how far he / she can push certain boundaries.  Just tossing that out there also.
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1118724 tn?1357010591
There is a connection between Stage 4 Hep C, cirrhosis, the spleen, and portal hypertension. Someone else will have to give an explanation, I can't, just know it exist.
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Avatar universal
Spleen was lost due to an accident back in '92, landing on handlebars is not a good thing, was in a coma for 10 days. It has been difficult finding muh on how having no spleen affects things. But, I have been told that high WBC is common in people with no spleen. Even though you can live without your spleen, not having one causes the WBC's to work harder to fight infections. If I forget about getting a flu shot, and I get the flu, I just don't get sick, I get SICK. With my last flu, I ended up having pneumonia also, which lasted close to 6 weeks. Anyway, I'll post more when I learn more, Thanks, Mike
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223152 tn?1346978371
Normally functioning WBC (white blood cells)

my typing leaves a lot to be desired
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223152 tn?1346978371
I really don't know much and certainly have never read about the impact of the loss of the spleen.  However, with normal fully functioning WHC high neutriphils would indicate that an infection was being fought.  So high numbers are not particularly a good thing.

What caused you to lose your spleen if you don't mind my asking?

Goof -What? You think I'm your pimp?    ha ha ---  but yes -- I am doing the investigation thing.  I do have an appointment in Dallas June 10.  They made it for me without my even responding to their phone call.  I hope it is just not a 5 minute meet and greet and let me tell you type of thing.  I don't know this doctor because mine quit and went elsewhere but the clinic is excellent.  Anyway I am going to check them out.

bean

f
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Avatar universal
White blood cells are made up on neutrophils, monocytes and lymphocytes primarily.
^ This is what I've also read, so if I was to go by all of my highs I should never get sick. Yet I know that people with no spleen are to have a low immune system, I've been told that I must be sure to get flu shots yearly and I also get a pneumonia shot every 4 or 5 years. Understanding how, and if my numbers will affect my treatment is difficult to say the least.
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92903 tn?1309904711
" ...using Goofy dad would be a lot more fun."

The line forms to the left, ladies. Please be patient and don't rush the gal in front of you.

Hello Beanie! Investigating the new drugs, huh? Tough decision forr you - are you thinking you'll jump back in?
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223152 tn?1346978371
White blood cells are made up on neutrophils, monocytes and lymphocytes primarily.  There are a few other minor white blood cells but those three make up about 95% of all the WBC.  Each type has a different job.  The neutrophils are the main infection fighter. There is pretty cool picture on wikapedia of a neutophil engulfing an anthrax bacteria.

So when your neutrophils drop you are in danger of infection.  Most informed doctors think we (hep C patients) are okay unless ANC drops below 500.  However, most hemotologists who work primarily with cancer patients, cannot let the ANC drop below 750 because of infections.  We do not seem to get those infections (for the most part).  

I can send you links to ANC calculators, but using Goofy dad would be a lot more fun.  So just forward all your info to him and let him do the calcs. Right, goof?


frijole
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Avatar universal
Well you do such a good job of it, that I thought it better left for you to explain that part.  As usual, you did not disappoint. :-\
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92903 tn?1309904711
Trish, You didn't adress the "absolute" part. I think it's lab talk. There's a lab lady at a microscope (usually with a box of twinkies at her side) and she's like that ain't no nuetrophil... that ain't no neutrophil, that one could be, ohhh lookie there, that one's a neutrphil fo' sure (ANC=1), not that one, nope, nope, there goes one (ANC=2), that one could be..naw probly not......this ain't one...ooo ooo there goes one.....  
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Avatar universal
I plan to ask more at my next regular doctor appt. soon, then will ask the same at the next appt with the ID folks. It just seems as though some highs are not so bad, while others are bad, it gets confuzzling for sure, searching on-line makes some things even more so. I'll post what I learn so as to give some info to others.
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Avatar universal
Sorry Jillybean....referred to you as Junebug.  Both cute nicknames and both start with "J" I guess. :)
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Avatar universal
Hi Mike,

I'm afraid I'm not much help to you.  The information I posted to Junebug is relatively basic stuff for someone on treatment and that's what it applies to.  Myself and others on treatment all had to deal with ANC levels and other blood levels while on treatment and then there are others with more advanced liver damage who have other blood markers to pay attention to.

I don't know much about the significance of your results, the high white counts and what that indicates and if it has any connection with lesions on your kidney and liver and while not on treatment so I don't know if any of this is something to be concerned about.  Perhaps other people who have some experience with your particular situation will chime in.

Trish
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Avatar universal
It sounds like you have some experience with this, so i thought I'd see what you thought of my results. First I'll give an update on my situation. I have not started any treatment as yet, waiting to check stability of lesions which were seen on one kidney and liver during biopsy. I am a GT1a, grade 2, stage 2, VL was just at 24mil back in October, also I have no spleen. My last CBC on 04/06/11 show several high flags. My WBC was @ 17.0 & platelets were @ 599, both of these are always high after having no spleen. Now the other highs, Neutrophils @ 7.9 (ref.int. shows 1.8-7.8)
         Lymphs @ 7.1 (ref.int. of .07-4.5)
          Monocytes @ 1.4 (ref.int. shows 0.1-1.0, all show units of x10E/ul
I don't go back to the Infectious Diseases folks until July 11th, at which time I will be asking about these highs, also I will be scheduled for another CT to check on the lesions again. This journey has only just begun, from what I've been reading. Anyway, if you can, please give me your thoughts, Thanks, Mike
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Avatar universal

Hi Jill.....often treatment meds ..usually the interferon can hinder your ability to make white cells. The absolute neutrophils ( ANC)..one segment of those is usually what they will keep an eye on   .. The normal level is a ratio of 1.5 to 7   or simply put   1500 to 7000.
If levels drop to <500 docs will usually intevene with a rescue drug called Neupogene to increase levels  to help you ward off any bacterial infections

Hope that help...
Will
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Avatar universal
This is ANC described in easy language.  It matters because the interferon can cause a drop in ANC and if it gets too low, it can make you vulnerable to infection.  Therefore it needs to be monitored and addressed during treatment.  I've seen that 500 count tossed around by different sources and that some docs will wait until 300 to intervene, depending on the situation.  Regardless, it's a key component to be monitoring while on HCV treatment.

"Neutrophils are key components in the system of defense against infection. An absence or scarcity of neutrophils (a condition called neutropenia) makes a person vulnerable to infection. After chemotherapy, radiation, or a blood or marrow transplant, the ANC is usually depressed and then slowly rises, reflecting the fact that the bone marrow is recovering and new blood cells are beginning to grow and mature.

In practical clinical terms, a normal ANC is 1.5 or higher; a "safe" ANC is 500-1500; a low ANC is less than 500. A safe ANC means that the patient's activities do not need to be restricted (on the basis of the ANC)."

http://www.medterms.com/script/main/art.asp?articlekey=20030
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