absolute neutrophil count (ANC),
the number of neutrophils in a milliliter of blood, having a reference value of approximately 1500-7700 per μL. The ANC is a measure of a person's immune status. Generally, if the count is above 1000, the person may safely mingle with other people or undergo chemotherapy, but a count below 500 indicates that a person is at high risk for infection and should be kept away from those with infectious diseases. Neutropenia by definition is an ANC below 1800/mm3. It is calculated by adding the number of segmented neutrophils and the number of basal neutrophils and multiplying the sum by the total white blood cell (WBC) count. The formula is ANC = Total WBC count × (% neutrophils + % bands)/100.
So basically, the percentage is higher because my RBCs are low, but the ANC is just based on the number of neutrophils... is that right? Remember you are explaining to somebody with brain fog... I need short and sweet so I won't forget the first thing I read before I get to the end.
This is one of my favorite site for lots of background information. It's easy to use (for example key 'CBC' into the search bar) and it gives good information in a fairly digestibe context.
"More important than the percentage of neutrophils is the absolute neutrophil count (ANC), which should fall between 1.0 to 8.0 k/ul. The reason the ANC represents the true clinical picture better than the percentage of neutrophils is that, in cases where blood counts are suppressed by therapy, the percentage of neutrophils will be higher when the overall counts are low. One may calculate the ANC by multiplying the percentage of neutrophils (in decimal form) plus the percentage of bands (in decimal form) by the total number of white blood cells. The number of bands is usually quite low or even zero, so one may also obtain a fairly accurate ANC by leaving the percent of bands out of the equation."
The bottom line is that you are not at risk of infection at this point. Relax, your numbers are pretty typical.
Neutrophils are the actual number of neutrophils in a milliliter of blood.
Absolute neutrophils are derived from what is called the differential: you take the total white blood cell count and differentiate the percentage of white blood cell species that make up the whole (neutrophils, eosinophils, basophils, lymphocytes and monocytes).
So if your total white blood cell count total is number X, and the differential shows neutrophils make up say, 1/3 of the total count, then the absolute neutrophils equal X times 1/3.
No, red blood cells are not a factor.
Neutrophils are just one of the many kinds of white blood cells. In your case, they compose 46% of the total white cells. The range (in percents) for neutrophils is 40-70% of the total white blood cells - so your neutrophil percentage is in the low range of normal.
The absolute neutrophils is the actual count -- the amount (K/uL but maybe someone else can define K and uL) of neutrofils you have. So the normal range for WBC is about 4-11 K/uL and the normal range for nneutrophils is 2-8 K/uL. If you add up all the absolute numbers in teh WBC section of your CBC it will equal your total WBC.
The bottom line is that your total WBC is low, so 46% of your total WBC is about 1.1 neutrophils. That would make your WBC about 2.4.
I think what you need to know here is that 1.1 is still a pretty good number for ANC when treating. Mostly doctors in the know don't worry about ANC until it hits about .5 (for hep C patients)
Since you neutrophil count is reported as percentage, then that is the differential - 46% of your white blood cells are neutrophils as opposed to the other species.
Your ANC is 46% times your total white blood cell count.
So, if your percentage of neutrophils is low normal, and your wbc count is low normal, then your ANC could easily be below normal.
Your abs neuts are perfectly fine. Most docs do not pay attention until they go under .5 as Michael said but even then they go up and down a lot and my doctor did not even make me take neupogen - he waited and they went back up on their own. Neup - unlike Epogen - works fast so worse case scenario they can fix it quickly should it happen.
You are quite fortunate your numbers are still holding very strong for this time in treatment!
I think I understand. After reading all the posts through a couple of times, it all stuck in the brain long enough to make sense of it.
Thanks for the explanations,
are you saying we are running this to the ground again?