Red cells, White cells

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Blood counts have become very important. Anna’s red blood, white blood and platelets are measured daily and give a good indication (to the doctors mainly) of how well she is doing.

This is my understanding of blood counts and Anna’s condition, based on biology O-level (a long time ago), lots of question & answer sessions with the doctors and as much googling as I can on an iPhone in a hospital ward with an intermittent 3G connection.

Red blood cells carry oxygen around the body. A normal level is between 120 – 140. Below 80 is low and is the trigger level for a blood transfusion.
Anna’s red blood count was 29 on the day she was admitted. She was clearly a very unwell girl.

There are 2 main types of white blood cells. Of these, neutrophils are a white cell type that fight infection. A normal neutrophil level is somewhere between 2 and 6. Neutrophil levels below 1 mean that you are neutropenic (a word we now hear a lot), that is, extremely susceptible to infection. Anna’s neutrophil level on admission was 0.96, is currently 0.33 but has been as low as 0.05. Infection is a huge danger to Anna when she doesn’t have the white cells to fight it effectively. So when she is neutropenic it is very important she is not exposed to any kind of infection.

Platelets make the blood clot. Normal levels are 150 – 400. Below 20 is low. Anna’s platelets were 23 when admitted and 23 yesterday. The level has gone up to 153 over the 3 weeks we’ve been here and then back down again. She has had several platelet transfusions.

Because the chemotherapy kills all cells, not just the leukaemia cells, it is normal for the levels of cells to be varied. However, the neutrophils are what we watch.

I need to apologise to everyone now because I might become quite obsessed with Anna’s neutrophil level over the next 2 years. I’m sorry if I say I can’t travel/see you/meet for coffee/let children play/do anything etc etc etc because Anna is neutropenic. Just please be patient with me and understand my very real concern that it could be dangerous and life threatening for Anna.

The Macmillan website is a fantastic resource for all kinds of information. You can see the website in the useful links page. Or click here to go straight to the section on acute lymphoblastic leukaemia (ALL) in children.

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