Low white blood cell count

barbara4

Hi,

I am 46 tears old, I underwent a double mastectomy in August 13/ 2020 for DCIS and my diagnostic was update to IDC as a 4mm tumor was found in the left breast with focal LVI and 0.3 mm micromets in 1 of the 7 nodes. I am on Tamoxifen. I was in a grey zone but the RO recomended radiation chest and lymph nodes. I complete the treatment in November 27/2020 that last almost 5 weeks. On Dec 23 I did blood work and my white blood cells are very low. (No blood work was done during the radiation treatment ). I was calm thinking that the results were low as it was the side effects of the radiation. However today, my family doctor called me concerned about the results. She said it could be the radiation or it could domething else. I will repeat the blood work in 1 month. I called the RO’s office to ask him about this, but the secretary did not take my message and she insisted that radiation does not affect the blood work. Is low white blood cells normal after radiation?

Thanks,

Barb

MinusTwo

Barb: If you go to my profile and enter previous diagnosis & treatment, it makes it easier for everyone to follow.

I've never heard of low WBC with radiation. I had low blood but only during chemo.

LillyIsHere

Hi Barb, my WBC went down after BMX and now they are barely climbing up. I will have my physical in January and I hope the numbers will continue to normal levels.

I wonder if other members have any experience with WBC count while going through treatments.

barbara4

Than you for your kind answer

ProudMom_Wife

Hi Barb,

All through treatments my white cell count was fine, BMX, chemo, reconstruction, and then I did radiation. I had almost finished treatment when my white cell count tanked. It finally came back up enough so I was able to complete radiation and then I started Tamoxifen.

Having low WBC with radiation can happen.

However, do not ignore it and make sure your doctors continue to monitor you and do not be shy about asking your doctors questions if you have concerns.

barbara4

Thank you

barbara4

Hi everyone,

I spoke with the RO, and he said that low WBC after radiation can sometimes happen. He said it should be transitory. He also said that if the WBC arestill low he recomends to investigate if the Tamoxifen could be triggering this. Does anybody has information about Tamoxifen and low WBC?

flashlight

Hi, My WBC after radiation was low, but that resolved. I have been on Tamoxifen for almost 2-years and haven't had a problem with my WBC. My PCP orders a CMP every 6-months. I had issues with an abnormal liver function levels so my MO ordered CMP every 3-months and finally this month they returned to normal. Hopefully you will see your count returning to normal after your next lab.

barbara4

Thank you Flashlight

KMom57

I’m 9 weeks out, and my lymphocyte level is also inthe tank. Worries me. It’s only the lymphocytes. Overall WBC is fine, I’m told because lymphocytes make up such a small (but important) percentage of the WBC. I know it’s radiation induced because my labs all the way through chemo and going into radiation were all completely normal.

barbara4

I am 9 weeks out as well. I almost always had low Neutrophils. Now my Neutrophis and Lymphocytes are low.

KMom57

Barbaraprevost4, I did a small bit of research, and it would appear radiation induced lymphopenia is a thing. If I understood correctly, the incidence goes up as the radiated field area goes up. I had extensive radiation including lots of nodes. I'm a little worried as my level actually dropped from one lab to the next the following week. Glad to hear your RO said it should be temp. Hope that's the case for me too.

barbara4

Thank you for your answer and the information KMom57. Yes, he said that, I hope our levelswill be better next time!

Barb

cm2020

My WBC count was still low in December and I finished radiation in early July. My MO wasn't concerned and said she saw it all the time after radiation.

barbara4

Oh, thank you cm2020

SUPer52

Hello all,

I thought I'd chime in here too because I have wondered about this myself....I remember when I was still undergoing radiation, I had my routine physical with my primary care physician who always orders blood work. I remember him telling me to wait at least two months until after radiation was complete to have my labs done because, in his words, "radiation can wreak havoc with the numbers." I had always had a lymphocyte count that ran high prior to my BC diagnosis (high enough that I had to see a hematologist at one point) but all other numbers had always been normal. However, after radiation, my lymphocytes decreased significantly (which put them back into the normal range, at the low end) as did my neutrophil count and my overall WBC, which have both hovered just barely within the normal range ever since I completed radiation (in 2019!) Just this past November, my neutrophils and overall WBC came back flagged as low and I had to re-test a month later. Incidentally, my potassium level was also flagged as low, and my doctor was more concerned about that. When I re-tested, the results showed that everything had gone back up but only back to the lowest end of normal. My oncologist wasn't concerned and didn't say whether radiation was or wasn't a possible cause but that she wanted to keep an eye on those numbers. I'll have another lab completed in early June, so I'll be curious to see where my numbers are. By then, I will be two years out from radiation.

barbara4

Thank you for your answer SUPer52

RatherBeSailing

I have to chime in, too, because I hate it when RO's say no side effects from treatment. Two years after radiation I had a lot of sinus infections, and was diagnosed with low T cell count (lymphocytes are made up of B and T cells.) Immunologist said it was a result of chemo and radiation. Period. No doubt.

Research shows wide radiation fields (think all of your nodes in addition to chest wall) increase toxicity to lymphocytes. And T cells are generated largely in thymus, which is near internal mammary nodes and shrinks with age, producing fewer T cells. So advanced age (60) plus a wide radiation field...

I hope I am an outlier. And hoping levels will still recover. But if you are having symptoms I would rely on your internist...

barbara4

Thank you for the information RatherBeSailing.That makes sense !

Barb