Blood Counts 101

Blood Counts for Children on Treatment: Children being treated for cancer experience wildly fluctuating blood counts. White cells can range from zero to higher than normal, whilst red cell and platelet counts may drop periodi cally during treatment, requiring packed red cell and/or platelet transfusions.  The absolute neutrophil count (ANC) should be closely monitored as it will give an idea of your child's ability to fight infec tions. ANC can range from zero to figures in the thousands. it is important that you know your child’s regular blood values and patterns as they are important in painting a picture of how he is likely to respond to his illness, its treatment, and possible infection.  His individual patterns are most important. For example, if the values of three tests are 5.0, 4.7 and 4.9, the second result is not important.  However, values or 5.0, 4.7 and 4.2 demonstrate a decrease in the cell line.  Therefore, it is important that you know your child’s regular blood values and patterns.  These changes may require transfusions, changes in chemo doses, and /or neutropenic precautions. ANC: Absolute Neutrophil Count  is a determination of a child’s ability to fight infection.  A child with an ANC greater than 1000 is generally considered to have near normal infection fighting capacity.  If a child’s ANC drops below 1000, he becomes neutropenic, meaning that his body is not adequately able to fight infection.  Severe neutropenia is characterized by an ANC of less than 500, and this can lead to life threatening infections.  Prolonged periods of neutropenia or a dramatic drop in counts may indicate a sepsis.  An ANC below 1000 will mean delaying chemo for the rest of the cycle and until the ANC is back up.  Therapeutic Ranges in LTM: Now that Sammy is in Long Term Maintenance (LTM) the goal is to have his nadir (lowest point of ANC level) reach the therapeutic range...in other words...the lowest it can be to kick cancer's butt without going below 1000.  At this point, almost half way through LTM, we still have not got those counts into the therapeutic range...thus, Sammy's chemo continues to increase.  This is frustrating beyond belief.  Apparently, it is better than some children's experience of having their ANC drop so low, they are constantly taken off treatment.  Such is the individual nature of this particular beast...every case is so different.   Normal Ranges for Blood Counts Hemoglobin 11.5-13.5 Platelet 150-400 WBC 4.5-13.0 ANC 1500-8000 Platelet < 20 = platelet trasfusion