Low white blood cells long after chemo
My wife was diagnosed Stage III in April 2009 and went through AC and Taxol chemos as well as radiation. In blood tests this year, long after chemo, her white blood cell counts have varied but are often in the low range. Her counts have ranged from about 2.5 to 4, but the latest was 3.0. She also had low platelet counts but that seems to have normalized. A bone marrow biopsy this year showed no problems, but now she's being scheduled to meet with a "benign" hematologist. Has anyone had this kind of experience, especially low white blood cell counts, and what light can you shed on it?
I appreciate your response.
Comments
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A nurse friend of mine warned me before I did chemo that one of the side effects is something called myeloproliferative disease. Essentially your bone marrow doesn't function the way it should. Sometimes it can lead into more serious blood disorders.
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My white blood counts remain below 4, usually aroud 3.2 to 3.6, and I finished chemo just about exactly two years ago. My onc says that chemo is the reason, that my blood counts otherwise are fine, and it will eventually get better. Who knows? More important, from an infection standpoint, is to calculate your absolute neutrophil count. If it is above 1500 (1.5) it is probably OK, but the higher the better. Mine runs around 2200 (2.2).
Marilyn
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I don't think it is really unusual. I had my last chemo 7/06 and my white count has never been where it was pre-chemo. Before chemo it was over 6, now it stays just slightly over 3, but I feel just fine and have no problems with it. Anyone know why the red blood cell count tends to bounce back and the WBC's lag behind?
Shirley
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My WBC & platlets have been consistantly low since chemo; onc. says this happens quite often, and is 'normal'; I feel fine, am not sick any more than usual (bruises take longer to heal); there is nothing I can do to change it, so I'm just not worrying about it.
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I have the same problem. My oncologist just ordered a vitamin b12 test, and it came back super low. He's recommending vitamin b12 injections which should help stimulate white blood cell production.
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Packer,
My platelets and red blood cells recovered well from chemo, but I was leukopenic (low total white blood cell count), neutropenic (low neutrophil component of white blood cell count) and lymphopenic (low lymphocyte component of white blood cell count) for more than a year after chemo ended. My total white blood cell count and neutrophil count edged up into the bottom range of normal about 15 months after the last chemo, I think. My lymphocyte count is still low.
I too had a bone marrow biopsy, about 5 months after chemo because my counts were so bad then, and it was normal. Not just OK, normal.
My oncologists (I see a regular one and a university-affiliated one) advise nothing more. At this point, I don't seem to get infections more than other people or than I did before chemo, although for quite a while after chemo I would be layed-out if I caught anything at all. So if I'm immunocompromised, it's not severe. The other question, which they are unable to answer, is if I have an increased risk of myelodysplasia or leukemia. I worry about that. But we're not doing any evaluation other than period CBC because, as far as I know, there's nothing I could do about it to prevent it even if I am at increased risk compared to someone who didn't develop these problems.
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I finished chemo Dec 2010, have had WBC around 3 since then. I was not told that this would be a long-term issue, but was warned about the possibility of myeloproliferative disorder, but the MO just used those words, but not what it might mean. So far I have had no problems with infection other than post-op wound infection last year after BMX. I agree with Outfield that there is nothing else we can do to prevent the myelodysplasia or other blood cell problems - that is now out of our control - once the chemo is done, it is done and has damaged whatever it's going to damage - we just wait and hope all is OK.
Another cause of low WBC is tamoxifen, so I would guess that chemo + tamoxifen might cause additional low wbc. -
It is not unusual to see low counts after cytoxic systemic chemotherapy. I am over years out from dx and I still run low WBCs. I do take a few supplements daily. Flaxseed, fish oil, etc. I find if I hold these supplement for a week, my counts bump up abit. My onc is ok with it.
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Hello
I was diagnosised with colon cancer with met to liver, underwent 12 sessions of First Line Chemo. My wbc count since has 98% of the time below the normal of 4, ranging between 2 and 3.4. In December 2012, I finally ask my oncologist concerning the cause but I already knew from research and other oncologists, his reply, "this is caused by chemo." My wbc for that month was 2.7. I have not had any problems but for me the concern is a low wbc means a reduced immune system to fight dieases, bacteria, fungus, etc., being around around pets and humans could eventually cause problems. Some people are more likely than other to get dieases from annimals...a person age and health status may affect his or her immune system again increasing the chances of getting sick. http://www.cdc.gov/healthypets/animals/dogs.htm
Charles
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My WBC is 3,3 over two years after finishing chemo. My platelets are also low at 130. I do find myself worrying about recurrence or other possibilities. But, I try to stop myself and stay in a healthy frame of mind.
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I finished chemo ten years ago. My CBC was completely wacky for the first five years with over half of the counts being way out of the normal range. Over time each value started to normalize. At my ten year check up everything was in the normal range except my WBC and platelets. My WBC consistently runs around 3.0 and my platelets bounce in and out of the normal range. My onc is also a hematologist and is fine with these values. Like Marilyn said above, the important count to look at is your absolute neutrophil count. Mine is usually around 2500 or 2.5 and I am never sick. Knock on wood!
This is my new normal.

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Has anyone had their lymphocytes stay as low as .6? I had chemo that ended in August 2014 and then radiation during October and November. My white count was up at 4 in February, and then it plummeted. But, my lymphocytes just seem to stay at .6. That seems very low to me. Has anyone had this as a longterm problem?
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HI 1Carol,
Welcome to the BCO community. We are so glad that you reached out to us. While you are waiting for some responses, here is some information on our site about the impact of chemotherapy Chemotherapy and its impact on the immune system. We look forward to seeing you on the boards. The Mods
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Hi. Is anyone with low neutrophils and WBC counts taking Tumeric? My white blood cells are consistently under 3.0 (2.7) and my neutrophils are very low at 1.2 (last blood work June 19, 2014). I used to be very worried about it but now I am pretty sure it is because of my tumeric and green tea consumption.
I am BRCA1 pos. and had my prophy procedures done in March 2013. Before the procedures I needed to go off tumeric 2 weeks prior (I also quit the green tea) and on the day of the procedure all my counts were in normal range (3.5 for WBC, etc.).
I figured the combo of green tea and tumeric daily was giving me a gentle type chemo. I rarely get sick and if I do it is just 5-7 days and gone.
I read somewhere (science daily I think) that neutrophil nets could possibly be a mechanism of metastasis seeding. So I went back on the tumeric and green tea. I have no clue what my numbers are now. I will book an appointment soon and get tested.
Just thought I would mention my experience.
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Kayrem, I have wondered the same thing about turmeric. My counts fell when I started it. Do you know what your lymphocyte count is? That fell for me too.
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Hi Carol - my lymphocytes were at 0.8 for 2 years after treatment (feb 2012, feb 2013), but went up to 1.2 in June 2014. WBC are consistently around 2.7 (ref range is 4.5 to 11) so always low. I would have been really worried but when I went off everything (tumeric, green tea) in Feb, March 2013 for my prophys, all my low counts went up to normal!
A year after my procedures (June 2014) everything was low again. I will be going to get my blood work done again soon and I hope my numbers are still low!
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Kayrem, Thanks for answering. I hope your numbers turn out in June the way you want. I feel like I keep catching every cold that comes along, and I guess it's low lymphocytes causing that. Everyone here says they didn't have that problem. I'm not sue what to think. My onc doesn't seem worried--but he's not the one getting sick all the time.
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So, I was worried about lymphocytes of .6. Just had a blood test and they were up to .9 (the bottom of normal). BUT, listen to this. Suddenly my neutrophils have fallen to 1.0. My oncologist seems unconcerned and he is a hematologist too. But, I remember that 1.0 as being the cutoff for chemo. It is a very low count. Has anyone had an experience similar to this?
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please post a reply why hb/wbc goes down after treament with trastuzumab and peggrafeel injection.
i have undergone 3 times this herceptin therapy and everytime my total count and hb goes down. for
the last therapy onco has advised not to take peg grafeel injection and get ( cbc) complete blood check
after one week.with peggrafeel i get fever and body pain.
Please advise.
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Hi birajadas, welcome to Breastcancer.org!
Until you get responses from other community members here, we recommend you take a look at this general explanation on How Chemotherapy Affects the Immune System from our main site.
Hope this helps!
The Mods
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I have the same exact thing. My treatment was TAC yep I got "The Red Devil". I am 3 years cancer free of stage 2 IDC. My last blood test showed my white blood cell count was a 4 and my platelets are a 3. I suffer from chronic fatigue and my doctor is telling why am I going to the gym with my immune system like that. I just had full blood work done today so we will see. My PCP is doing the blood work not my Oncologist.I have read on here where a woman had the same treatment that I had and 10 years late she is still has the same wbc and platelets. I don't know I had the Nulasta shot the day day after chemo. That was horrible. The worst pain of it all. Stay in touch and I will let you know how it goes

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My wife had low counts, even six years after chemo (FEC-T). She went on mushroom supplements and her neutrophil count over doubled in only weeks. Sound too good to be true? Look up the study done in the US. They gave Maitake D extract to patients with myelodysplastic disease, and they experienced improved counts as well.
https://www.ncbi.nlm.nih.gov/pubmed/25351719
There don't appear to be any contraindications, aside from allergies or low blood sugar levels. Dosage is important in that too much will be suppressive of some measurements of the immune system, For maitake D extract, 3mg / kg body weight, 2x daily appears to be optimal.
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hi everyone. Glag to have bumped into this thread. I am doing neoadjuvant chemo, just finished taxol #7/12. Neutrophils count has been under 2 for at least last ten blood tests. Taxol treatment was delayed three times due to low neutrophils count. I have been wondering if my count would ever bounce back to normal. Now I have some idea what to expect. Thanks for your experiences.
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suziq1960- I just ran into this thread and saw your post. I'm a year out from neoadjuvant chemo, had some complications (of course lol), and I'm still hovering with lower white and red cell counts, and platelets. MO is requesting blood work every 2 mos to monitor, and thinks it's residual from the chemo. Not liking it with all this flu scare going around! I feel like I'm fighting some kind of cold right now- frustrating as I was pretty healthy before.
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Hi, I’m six months out from finishing chemo and my white blood cell counts are still low, under 2. I’ve done everything I can to lift them but not much seems to work. Having said that, I’ve managed to avoid contracting any infections. Fingers crossed it stays that way.
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