Testing: Blood Counts

Hemocytometer, photo by Todd

Blood counts can be used to identify disease and monitor patient health during cancer treatments. Though these tests cannot diagnose lymphoma on their own, they can alert doctors to a problem in the body, prompting them to conduct the appropriate tests. Since most chemotherapy regimens result in low blood counts, these tests become very important in monitoring patient health once a diagnosis is made.

Blood tests are used to measure and inspect the red blood cells, white blood cells, and platelets. A complete blood count (CBC) will test all three cell types. This test requires only a few drops of blood to conduct.

Almost all cell counting is done via machine, though hematology technicians (specialists in bloodwork) will look at the blood cells under a microscope as well to ensure there are no abnormalities in shape or size.

Red Blood Cells (Erythrocytes, aka RBC)

RBC Count

Red blood cells carry oxygen from your lungs to the rest of your body. A depletion of red blood cells can lead to anemia, which results in fatigue, dizziness, or more serious symptoms if left untreated. Typical RBC levels are:

• 4.5 to 6.2 million cells per microliter of blood for men
• 4.2 to 5.4 million cells per microliter for women
• 2.6 to 4.8 million cells per microliter for children

Hematocrit

The amount of RBCs is also shown via the Hematocrit, which is a ratio of the number of RBCs to the volume of blood. Typical values are:

• 42%-52% in men
• 37%-47% in women
• 36%-40% in children

Hemoglobin

Hemoglobin is a molecule on a RBC that allows it to carry oxygen. Low hemoglobin counts can also result in anemia and fatigue. Typical levels are:

• 13-18 grams per deciliter in men
• 12-16 grams per deciliter in women
• 11 to 13 grams per deciliter in children

White Blood Cells (Leukocytes, aka WBC)

WBC Count

White blood cells contain the immune cells that attack and remove bacteria and viruses in the body. Low WBC counts can indicate that a patient is in danger of infection. High WBC counts can indicate an existing infection, leukemia, or tissue damage. Typical levels are:

• 4,000 to 10,800 cells per microliter of blood.

There are many different types of WBCs, and their values differ. They are:

• Neutrophils (50%-60% of all WBCs)
• Eosinophils (1%-4% of all WBCs)
• Basophils (0.5%-2% of all WBCs)
• Lymphocytes (20%-40% of all WBCs)
• Monocytes (2%-9% of all WBCs)
• Absolute Neutrophil Count (ANC)

Neutrophils are the body’s first line of defense against infection and disease. These special cells help with inflammation as a result of bacteria or cuts in the skin, and they are responsible for pus. A low level of neutrophils (called neutropenia) leaves a patient susceptible to disease. Obesity and smoking increase neutrophil count - for each pack of cigarettes smoked per day the granulocyte count can increase by 1000/µL

An ANC reflects the number of cells in a microliter of blood. This level is usually above 1000 cells per microliter, though chemotherapy depletes this count.

Lymphocytes

B-cells and T-cells are lymphocytes. Depletion of these levels can also increase a patient’s risk of infection. Typical levels are:

• 1500 cells per microliter of blood for adults
• 3000 cells per microliter of blood for children

Platelet Count

Platelets are responsible for blood clotting. Typical levels are: 133,000 to 333,000 platelets per microliter of blood. If this level decreases to below 30,000 (called thrombocytopenia) then abnormal bleeding can occur. Counts below 5,000 are life threatening.

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Dive Deeper

Online Resources

• Blood Counts for Kids University of Iowa
• Understanding Blood Counts - US Leukemia & Lymphoma Society

For more information on Hodgkin's Lymphoma, please see the following pages:

• Chemotherapy
• Treatment
• Introduction

For more information on Non-Hodgkin's Lymphoma, please see the following pages:

• Chemotherapy
• Treatment
• Introduction