Where Oh Where Have My Neutrophils Gone?

In advance of tomorrow ' s planned fourth Darzalex infusion, the doctors did a CBC with differential today to see how my neutrophils were standing up to the Darzalex / Pomalyst combination. Surprise! Neutrophils were just 400/uL, where the reference range for this lab is 1800 to 7700 /uL. In other words, my neutrophils measured less than one fourth of the value representing the very bottom of the reference range - the lowest count that I remember in almost 13 years with myeloma. Doctors and nurses were all asking if I felt OK, because a low neutrophil count (neutropenia) can result inneutropenic fever, potentially a life-threatening condition. In the past my doctors have stopped treatment when neutrophils dropped below 1000. So what do we do about that? I have a Darzalex infusion scheduled for tomorrow. First, I don ' t believe the number. I don ' t doubt the accuracy of the test (much), but I have a history of low neutrophil counts that probably weren ' t low. The neutrophils are actually there, but they don ' t show up (at least not as neutrophils) in a CBC with diff. In the past, I have used two " tricks " to make the neutrophils appear: Take the blood in the afternoon. I have repeatedly found that my neutrophil count is at least double in the afternoon. In lieu of afternoon, take the blood as late in the morning as possible. Today ' s draw was at 7:30 am.Do some physical exercise just before the blood draw. ...
Source: Myeloma Hope - Category: Cancer & Oncology Tags: neutropenia neutrophils Source Type: blogs