Blood counts of children being treated for leukemia fluctuate wildly. White blood cell counts can go down to zero or be above normal. Red cell counts go down periodically during treatment, necessitating transfusions of packed red cells. Platelet levels also decrease, requiring platelet transfusions. Absolute neutrophil counts (ANC) are closely watched, as they give the physician an idea of the childs ability to fight infection. ANCs vary from zero to in the thousands.
Oncologists consider all of the blood values to get the total picture of the childs reaction to illness, chemotherapy, radiation, or infection. Trends are more important than any single value. For instance, if the values were 5.0, 4.7, 4.9, then the second result (4.7) was insignificant. If, on the other hand, the values were 5.0, 4.7, and 4.6, then the trend would indicate a decrease in the cell line.
The explanations below will describe each blood value. If you have any questions about your childs blood counts, ask your childs doctor for a clear explanation. Especially in the beginning, many parents agonize over whether the rapid changes in blood counts (often requiring transfusions, changes in chemo dosages, or restrictions on the childs visitors) are normal or expected. The only way to address your worries and prevent them from escalating is to ask what the changes mean.
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