neotrophils down to 42% going into surgery

[merryBe]

my neutrphils are down 15% in just 2 weeks...from 57 to 42 percent,
and my gall bladder/exploratory surgery in on Monday, while on treatment INF/riba.
is this something I should be concerned about?
the surgeon did not want to put me on Neupo at 57%...but should I ask again??
or is this no big deal??
ideas anyone?

[jdwithhcv]

Best of luck, I be thinking of you.  Be well.
JD

[jmjm530]

Facta: "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)."
----------------------------
Interferon induced neutropenia (low ANC), unlike low ANC with cancer patients, is not associated with higher infection rates and therefore the warning about restricted activities should be tempered accordingly.
http://www.hcvadvocate.org/hepatitis/hepC/Neutropenia.html

[merryBe]

thank you all for the good imput, I guess I'm still OK, but since the surgeon is out of town, I couldn't call and ask him.
Hopefully..I'll remember to mention it tomorrow....at 5 30 AM....giggle. that's if I sleep tonight.

all I  can do is hope right now, this abdominal pain on top of treatment has to go!!!

looking forward to sitting up and visiting again, soon as I'm through this.

You are all great friends, thank you!!
maryB

[kcrandy]

my neutro's hovered around 1.9 to 1.0 and i had an angioplasty on my heart during tx and the cardio was only concerned with my platelets being to low for clotting.  nothing in my case was ever brought up about my neutro's.

dont know if this helps any but i will be pulling for you thru surgery and complete recovery as well. :O)

[Facta_non_verba]

The ANC is calculated from you CBC results. Here's an explanation from MedicineNetdotcom:



Definition of Absolute neutrophil count

Absolute neutrophil count: The real number of white blood cells (WBCs) that are neutrophils. The absolute neutrophil count is commonly called the ANC.

The ANC is not measured directly. It is derived by multiplying the WBC count times the percent of neutrophils in the differential WBC count. The percent of neutrophils consists of the segmented (fully mature) neutrophils) + the bands (almost mature neutrophils). The normal range for the ANC = 1.5 to 8.0 (1,500 to 8,000/mm3).

Sample calculation of the ANC:
WBC count: 6,000 cells/mm3 of blood
Segs: 30% of the WBCs
Bands: 3% of the WBCs
Neutrophils (segs + bands): 33% of the WBCs
ANC: 33% X 6,000 = 2,000/mm3
ANC of 2,000/mm3, by convention = 2.0
Normal range: 1.5 to 8.0 (1,500 to 8,000/mm3)
Interpretation: Normal

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).

[wyntre9]

Cited wrong stats!  those numbers were for WBC.

neuts (ANC)  went down to .7 during first 3 weeks and have hovered around 1 to 1.5 ever since.  not that low.

GL,

wyn

[Xenigma]

I use labcorp and it is listed in the CBC w/differential part
of the bloodwork print out - below the...
Neutrophils
Lymphs
Monocytes
Eos
Basos
*Then comes all the absolutes of the above with neutrophils being first...
Neutrophils (Absolute)
Lymphs (Absolute)
Monocytes (Absolute)


I know different labs write it out different ways.  
Best to call your lab and ask how they have it listed
so you don't have to guess.
enigma

[Bobby1952]

I keep hearing about ANC or #NE on the CBC. There is no such thing listed on any of my CBC's. I looked back for 2 years. Never anything like that listed. I have Neutrophils and Neutrophils automated which are always the same. Is this an extra test or do some labs do it differrently??
Thanks
Bob

[Xenigma]

Good luck with your surgery.
They usually draw blood right before the surgery
to make sure numbers are good.  
I'm sure all will be fine.
enigma

[frijole]

Neutophils are the main infection fighting type of white blood cell.  The percent range for neutophils is 40-70% -- so you are on the low end, but not out of range yet (47% of your total white blood cells are neutrophils).  Most of us were fighting not to be put on Neupogen since we (hepatitis C treating patients) have shown to be able to withstand lower neutophils than cancer patients without infection.

If you are comfortable with your surgeon, I would not push the issue.  Do you know what your absolute neutrophils are?  They are shown as "ANC or " #NE" on your CBC.  

Sorry you have to endure surgery on tx. I will be thinking of you.
frijole

[wyntre9]

Good luck with the surgery.

About the neuts - mine tanked 75% in the first 3 weeks and have hovered around
1.8 - 2.2 ever since.

I'm on neupogen twice monthly.

But I dunno the answer about the effect of low neuts on surgery.

wyn