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Neutrophils and how to count them
There seem to be different ways of counting and recording these. My husband is on Day 18. I read that they need to be at 50 before he can be discharged and 5000 to be ‘normal’ but the measures seem to depend on how they are expressed. I don’t need a full pharmacological explanation, but they are currently 0.42. On whatever measure that suggests, what should we be expecting to hear before he can be considered fit for discharge.? And what would ‘normal. be?
Comments
Hi Mel,
Thanks for your post, I am the lead nurse at Anthony Nolan. It can be confusing when we talk about what levels the bloods need to be but you are on the right track. Normally the white blood cells are the first numbers you look at because these include all types of white cells, once the white cells start to come up above 1.0 then you know that there is activity in the bone marrow. That is when you can look at specific white cells and the one we are most interested in is the neutrophils. Although there might be slight variations between transplant centers generally the neutrophils need to be 0.5 or above to be discharged. This means that it is safe and there is some protection from the immune system. Discharge will also depend on how well the patient is and other side effects of treatment. The 50 marker that you have read is the equivalent of 0.5, so as your husband's neutrophil count is 0.42 he is nearly there which is great. This can still fluctuate a little bit, so don't worry if it does as its normal, he is still very early after his transplant and his immune system is still recovering.
What is considered a normal neutrophil count can vary a bit but anything above 4-7 million although some labs will use a slightly lower range. It will take many months for the white blood cells and neutrophils to begin to get back to normal so as hard as it might seem, try not to think about those numbers. At this point and in the next few months the transplant team will want to see that his blood counts are going up, even if its slowly and that will be all that they expect. If you are concerned about his blood counts at any time, I would suggest that you talk it through with his team and they can explain what it means and where they expect him to be.
You are also always welcome to give us a call if you want to talk this or anything else through on 0303 303 0303,
Best wishes
Hayley
Perfect. Thank you, especially for quick response.