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Suffering from cyclical neutropenia. Results seem bad. Have terrible back pain. Related?

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Practicing since : 2002
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i suffer from a condition known as cyclical neutropenia. I have been dealing with blood draws and been treated by hematologists my entire adult life. I just received my most recent lab work from my general practitioner and she is quite concerned. My hematologist is unavailable for 2 weeks. Need I worry? By the way I have experienced terrible back/leg pain in the last week. Here are some of my lab numbers:
WBC is 2.2
Neutrophils are at 0.0
Mixed % 0.0
Lymphs are at 71.1
segmented neutrophils are at 10
Bands 2
Lymphocytes are at 83
MPV 8.8
MCV 89.9
MCH 30.2
MCHC 33.6

The rest of the numbers appear to be in the "normal" range.

Thank you very much!
Posted Tue, 22 May 2012 in Blood Disorders
Answered by Dr. Robert Galamaga 3 hours later
Hello and thank you for sending your question.

Your question is a very good one and I will work on providing you with some information and recommendations regarding what is going on.

First of all I do not think that any of your leg pains are related to the blood counts which you have reported. Sometimes if the patient becomes anemic or has a low iron level it can cause intermittent leg pains. In your case I suspect the lake discomfort is due to a musculoskeletal costs such as arthritis or a pulled muscle.

The white blood cell conch you have reported shows that your approximate neutrophil count is 200. I wonder if your hematologist in the past has given you injections of growth factor stimulators during these periods where your neutrophil count is low.

Otherwise we would expect that your neutrophil count will slowly improve within the next 5 to 7 days. This is the general pattern in a patient who has a cyclic neutropenia.

Usually when a physician goes on vacation another physician with a equal expertise will cover for him. Have you tried calling your hematologist office? If that is not an option I would suggest having a repeat blood count drawn at the end of the week to see if the trend in your neutrophils is improving.

I thank you again for submitting your question. I hope you have found this response to be helpful. I am certainly available if you have any additional concerns related to this question.


Dr. Robert

Above answer was peer-reviewed by
Follow-up: Suffering from cyclical neutropenia. Results seem bad. Have terrible back pain. Related? 38 minutes later
Thank you Dr. XXXXXXX

Any comment on what I have been told is the elevated LYMPH count of 71.1? Ive been told that the normal range should be in the area of 20.-45.

What does this elevated LYMPH count mean???

Thanks again.
Answered by Dr. Robert Galamaga 7 hours later
Hello and thank you for the follow up question.

The elevated lymph count is most likely a sporadic abnormality. this does not mean that some type of worrisome disease process is going on.

Also in your case since you're neutrophil count is low this will generally translate into a situation where the remainder of the blood cells are slightly higher than normal. remember the blood test is calculating the percentage of all white blood cells which are lymphocytes. in your case since you're neutrophils are depressed at this time the percentage of lymphocytes will automatically be higher. I suspect during times where you're neutrophil count is closer to the normal range that the leukocyte count is within normal limits.

Thanks again for submitting your question. I hope you have found this to be an informative experience. If you have additional concerns I would be happy to address them.


Dr. Robert
Above answer was peer-reviewed by
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