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Low white blood count; Should I get a bone marrow examination?
Mar 17, 2002

I have been told to take a bone marrow test because I have a low white blood cell count 2600 with 33% neutrophils and 9% atypical lymphocytes; hematocrit 38.5.

Do you know what this all means? What could be the worst case scenario?

Response from Dr. Dezube

White cells are the the cells that help fight off infection. A white count of 2600 (also referred to as 2.6) is indeed low, though not very low. Typically the white count should be above 4000 (also referred to as 4.0). Sometimes a bone marrow examination is performed to help figure out what's going on. It's difficult to comment as to whether or not you should have a biopsy without knowing much more about your situation.

Are you HIV positive? If so, do you have symptoms (fever, chills, night sweats, weight loss). If so, then a low white count could be a sign that something else is going on.

Are you an any medication which could lower your white count? If you are taking AZT, then a low white count is to be expected.

Are you an African-American? African-Americans typically have lower white counts than Caucasians. The lower white counts in African-Americans usually cause no problems and represent nothing more than an interesting laboratory finding.

Have you recently been ill. It is not unusual that after a viral infection (e.g. the flu) that the bone marrow temporarily slows down. As a consequence, you can get a low white count on that basis.

It's also important to know how long you've had a low white count. It is not unusual for low white counts to be transient in nature, lasting typically a few weeks. Have you seen a hematologist? (S)he should be able to help you assess the situation.


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