February 15, 2006 - White Cells A-Rising

Late this afternoon, I go for a blood test, and discover to my surprise that my white blood-cell count is way up. My white cells are at 18.5, when the normal range is between 4.5 and 10.5. The number on the report that’s been described to me as my “baby white blood cells” – white cells in the process of being manufactured – seems even higher, compared to normal: it’s 15.3, out of a normal range of between 1.4 and 6.5. All my previous CBCs (complete blood counts) have listed the white cells as between 5 and 8.

This is baffling to me, because I’ve been led to believe that a low white-cell count is the real bugaboo during chemotherapy. When the number of white cells is low, it typically means the immune system is suppressed, and the body is vulnerable to all kinds of infections it could ordinarily fight off on its own. My count today, though, is abnormally high – which would seem to me to suggest either that (1) my body’s issued a general call-to-arms to fight off some infection, or (2) the Neulasta shot I had on Friday has so pumped up my white-cell count that the little critters are popping out all over the place. I’m not feeling ill (other than ordinary post-chemo malaise), and I have no fever, so I have no reason to suspect an infection.

On blood-test days I don’t usually see the doctor, but I do have a brief opportunity today to ask Vanessa, one of the nurses, about the implications of these numbers. She doesn’t seem overly concerned, explaining that the abnormally high number of white cells is likely just a product of the cancer itself.


(White blood cells as seen under an electron microscope)

Still, I can’t help wondering about this number, because I’ve never seen anything like it on my previous reports. I go home and do a little snooping on the web, and quickly discover that I’m out of my element. I can converse fluently in terms like “eschatology” and “hermeneutics” – and could even explain the meaning of “the teleological suspension of the ethical,” if pressed – but when it comes to words like “hemocrit” and “monocyte,” my mind glazes over. Analyzing one’s own CBC is evidently one of those “don’t try this at home” kinds of activities, unless you happen to be a microbiologist.

One website I did find suggested that, when chemotherapy is doing its job fighting lymphoma, the malignant white cells that have been congregating mostly in tumors get dumped into the blood, and often show up in the CBC as though they were normal white cells. If that’s the case, that would seem to be a good thing – for it would mean the chemo is in the process of giving the cancer cells the old heave-ho.

But the bottom line is, I don’t know enough to say one way or the other. Maybe tomorrow I’ll call the doctor’s office and see if I can find out more...