What Blood Counts Mean - from Stephanie

Just a quick overview about what the numbers mean. Every day they are checking Mom’s blood counts. They check the white blood cell count, red blood cell count, platelets count and absolute neutrophil count (ANC). Today they are 32.5-R/110-W/44K-P/ANC-44).

Leukemia is cancer of the white blood cells. In order to cure this disease, they wipe out the bone marrow, which is where all blood cells are created. There is just no way to wipe out only the bad cells, so they wipe out everything. They then give the patient donor bone marrow and wait for the new marrow to grow and make new blood cells.

As we are waiting, we expect low numbers of all the blood cell types. If the red blood cell numbers fall too low (as measured by the hematocrit), then Mom gets blood transfusions. If the platelets are too low, then they can also be given by transfusion.

It is the white count and most especially the ANC that are important in determining when Mom goes home. The ANC is the absolute neutrophil count. Neutrophils are one subset of white blood cells and they are the cells responsible for immunity against infections. Mom needs to have an ANC above 500 in order to go home. Her count today is 44. We expect it to drop to zero in the very near future and to stay there for a while. Then it will gradually rise as the donor marrow begins to take root inside her bone marrow and begin to produce new blood cells.

Once the ANC reaches that magic number of 500, she should be OK to go home. At that point she will still be at some risk for infection, and will have to take precautions like staying at home and wearing a mask around others until her ANC count reaches the 1500-1800 range.