What does a rise in WBC count after Nplate procedure indicate?

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Posted on Tue, 16 Jun 2015 in Blood Disorders
Question: I have ITP and have been taking Nplate for about 21/2 years my Platelets have remained 50+ but my WBC has gone up from normal to as high as 20.1 it will veries but always in the teens. . my HGB is in the 1300s I do not have a a enlarged spleen or liver I am healthy no weight loss or any other signs. illness. Do you feel this rise in WBC is from the reaction from the NPLATE. I took a bone marrow .biopsy a couple years ago and it was normal. I am going to request my DR to give me another Bone marrow biopsy. I am worried that it copuld be leukemia.
doctor
Answered by Dr. Hardik Sanghvi 52 minutes later
Brief Answer:
It can be due to some infection.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern. You have ITP. Your total wbc count is high. But it may be due to some infection. Chances of leukemia are less likely.
Please send me your complete blood count report. Leukemia can be diagnosed from complet blood count and peripheral smear examination. I don't feel there is a need to go for bone marrow examination directly at this point of time.
Please send me your reports so that I can help you further.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Hardik Sanghvi 27 minutes later
Red blood cells count 4.10 - 5.70 M/uL 4.59
Hgb 13.0 - 17.0 g/dL 13.0
Hematocrit 39.0 - 51.0 % 41.1
MCV 80 - 100 fL 90
RDW, RBC 12.0 - 16.5 % 15.1
Differential panel MAN DIFF
WBC COUNT 3.5 - 12.5 K/uL 20.2
Platelets count 140 - 400 K/uL 118

neutrophils % 30 manual count
lymphocytes % manual count 61%
monos % man count 5
lymphocytes atypical % 4
platelets,bld,ql, man count si decreased
platelets, morphology Giant
macrocytes 1+
microcytes 1+
spherocytes,bld,ql, light microscopy 1+
rouleaux,bld,ql, light microscopy 1+
smudge cells,bld,ql, light microscopy
doctor
Answered by Dr. Hardik Sanghvi 2 hours later
Brief Answer:
You should go for bone marrow biopsy.

Detailed Answer:
Hi, dear.
I have gone through your reports.
Your total count is increased with high lymphocytes. It also shows some atypical lymphocytes. It may be due to some early leukemia or viral infection. You should go for bone marrow biopsy and if needed go for flow cytometry test. It will give you exact idea. Then you should take treatment accordingly. Your high count is not due to Nplate. So don't worry about that. Continue your Nplate in prescribed dosage.

Hope I have answered your question. If you still have any doubts then feel free to ask. I will be happy to answer you. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Hardik Sanghvi 8 hours later
WHAT WILL THE BONE MARROW BIOSY SHOW . WHAT IS THE USUAL TREATMENT FOR EARLY LEUKEMIA IF I HAVE IT. MY NUMBERS HAVE BEEN HIGH FOR A LONG TIME .BUT THEY GO UP AND DOWN . THANK YOU FOR YOUR GREAT INTERPRETATION OF MY TEST.
doctor
Answered by Dr. Hardik Sanghvi 7 hours later
Brief Answer:
You may have chronic lymphocytic leukemia.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Bone marrow biopsy will show high number of lymphocytes. It may show some blast cells and smudge cells. Flow cytometry will give you exact diagnosis regarding type of leukemia.
You may have early stage of chronic lymphocytic leukemia.

Treatment depends on type and stage of leukemia.
In early stage of chronic lymphocytic leukemia no treatment is required. Just wait and watch approach is followed. In late stage chemotherapy is required.

Just go for bone marrow biopsy and flow cytometry. Get exact diagnosis. And then take treatment accordingly.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7039 Questions

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