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Testing: Blood Counts

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Blood cell counts are used during diagnosis, treatment, and follow-up to determine the health of the patient.  Blood counts cannot by themselves determine whether a person has lymphoma but there are values that can determine whether everything is fine or if more tests are needed.  During treatment blood counts are very important to determine if that treatment is depleting healthy blood cells in addition to cancerous cells.
 
Below several types of blood tests are described.  There may be additional tests prescribed by your medical team.  Typical values are listed as "standard" ranges although these vary and you should consult with your medical team for complete information.

CBC - Complete Blood Count: This is a collection of tests including hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular volume, platelet count, and white blood cell count.

RBC - Red Blood Cell (Erythrocyte) Count: the number of red (oxygen carrying) blood cells in a standard amount of blood.  The count depends on how you state the values.  Typically:

  • Men 4.5 to 6.2 million cells per microliter (µL)
    Women 4.2 to 5.4 million cells per µL
    Children 4.6 to 4.8 million cells per µL

Some other red blood cell values tested:

Hgb or HB - Total Hemoglobin Concentration: hemoglobin gives red blood cells their color and carries oxygen.  The amount is typically:

  • Men: 13 (or 14) to 18 grams per deciliter (dl)
    Women: 12 to 16 grams per dl
    Children 11 to 13 grams per dl

This test can help determine the severity of anemia or polycythemia.

Hematocrit (or PCV for Packed Cell Volume): the total number of erythrocytes relative to the total volume of blood in the sample. It is written as a fraction or sometimes as a percentage. Typical values are:

  • Men: 0.42 to 0.52  (42% to 52%)
    Women: 0.37 to 0.47  (37% to 47%)
    Children: 0.36 to 0.40  (36% to 40%)

Anemia is a low number of red blood cells or reduced hemoglobin.  This can cause fatigue, weakness, light-headedness and in the most severe case lead to stroke or heart attack.

 

RBC Indices

There are three indices used to measure the size of red blood cells and the amount of hemoglobin in each:

MCV - Mean Corpuscular Volume: the volume of red blood cells. Typical values are:

  • 76 to 100 cubic micrometers (µm also called femtoliters fL)

MCH - Mean Corpuscular Hemoglobin: the amount of hemoglobin in the average cell.  Typical range is:

  • 26 to 32 picograms (pg, 10-12 gram)

MCHC - Mean Corpuscular Hemoglobin Concentration: the average concentration of hemoglobin in the red blood cells.  Typically:

  • 32 to 36 grams per deciliter (g/dL)

WBC - White Blood Cell Count: the total number of white  blood cells (leukocytes) in a standard sample of blood.  The count depends on how you state the values.  Typically:

  • 4000 to 10800 cells per microliter (µL)
  • 4.0x109 to 10.8x109 cells per liter (L)

Factors such as exercise, stress, and disease can affect these values. A high WBC may indicate infection, leukemia, or tissue damage.   There is increased risk of infection if it falls below 1000 cells per microliter.

White cell counts are determined by computerized cell counting equipment.  The machine determines the total count and the percentages of the five major white cell types.

WBC Differential Values (typical)
 

Cell Type WBC Percentage Number per microliter
Segmented Neutrophils 50% to 60% Total:1160 to 8300 blacks
1700 to 8100 others
Band Neutrophils 2%
Eosinophil 1% to 4% 0 to 400
Basophil 0.5% to 2% 0 to 200
Lymphocyte 20% to 40% 1000 to 4800
Monocyte 2% to 9% 200 to 950
 
Absolute Neutrophil Count (ANC) is an exact count of neutrophils (also called granulocytes), usually in 1x10-9 liters (microliters or µL). When the number of neutrophils falls below 1.0 (1000 cells per microliter) the condition is called neutropenia.  Neutrophils are important for fighting infection and a lack of neutrophils can leave a patient susceptible to infections.  Lymphoma treatment can cause neutropenia.  Drugs such as G-CFM and GM-CFM may help stimulate neutrophil production.  Obesity and smoking increase neutrophil count - for each pack of cigarettes smoked per day the granulocyte count can increase by 1000/µL

Lymphocytes are divided into B (bone marrow matured) and T (thymus matured) lymphocytes.  If the lymphocyte count falls below 1500 cells per microliter for adults or 3000 cells per microliter in children the condition is called lymphocytopenia.  Lymphomas can cause lymphocytopenia.

Platelet Count

The number of platelets in a standard sample of blood.   Typical range:

  • 133000 to 333000 platelets per microliter (µL)

Platelets (thrombocytes) are cell like particles that stop bleeding by gathering at a site where bleeding is occurring.  They then activate and clump together to stop bleeding and promote clotting.

Platelet counts increase during strenuous activity and if the patient has a myleoproliferative disorders including infection, inflammation, malignancy, and if the spleen has been removed. An excess number of platelets is called thrombocythemia.

Thrombocytopenia occurs if the count falls to below 30000 - abnormal bleeding can occur.   Counts below 5000 are life threatening.

Blood Count Resources and References

For more information on Hodgkin's Lymphoma, please see the following pages:

Adult: [Chemotherapy] [Treatment] [Introduction]
Childhood: [Chemotherapy] [Treatment] [Introduction]

For more information on Non-Hodgkin's Lymphoma, please see the following pages: :

Adult: [Chemotherapy] [Treatment] [Introduction]
Childhood: [Chemotherapy] [Treatment] [Introduction]

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This page is a work in progress - if you have more complete information, references, or other information please contact the author. The author is not in the medical field and does not warrant the correctness of the material on this page or the sites linked - please take online information and consult with your own medical team to make informed decisions.

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Updated November 25, 2005