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Why Are My Neutrophils and Platelets Monitored So Closely?

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Published on May 11, 2017

Why does my doctor monitor my neutrophils and platelets so closely? Patient Power founder, Andrew Schorr, poses this question to Dr. William Wierda and Dr. Susan Leclair. The experts explain the importance of these blood cells and what changes could potentially indicate about a patient's disease.

Sponsored by AbbVie. Produced by Patient Power in partnership with AACC's Lab Tests Online and The University of Texas MD Anderson Cancer Center. These organizations have no editorial control. Patient Power is solely responsible for program content.

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Transcript | Why Are My Neutrophils and Platelets Monitored So Closely?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

So when some of us are in treatment, depending upon what our treatment is, sometimes you worry about certain kinds of cells.  One kind of thing are the neutrophils and our ability maybe to fight infection.  I know when I went through chemo and all that my neutrophils got low, and I was being told maybe you shouldn't shave with a regular razor and such.  So is that an example of something, Bill, that comes out of the neutrophils that you're watching related to a red flag perhaps?                                 

Dr. Wierda:

Right.  So when patients are on chemotherapy, particularly the chemotherapy is toxic to the leukemia that's in the bone marrow but also to the normal cells. 

And so one of the things that we have to monitor are the blood counts and the differential and the percent of neutrophils, because we don't want to give too much chemotherapy. And we don't want to give it too soon, the next cycle too soon because you can compound the toxicity. 

So in your example for sure what we do monitor is the neutrophil count and making sure that it doesn't go too low and that it recovers in a timely fashion so that the patients are ready and able to go on to the next cycle of treatment.  So neutrophils we pay very close attention to, also the same holds for platelets. 

Andrew Schorr:

Okay.  And platelets then—and my platelets are monitored with a MPN and actually an effect of the medicine I have too is my platelets, and I'll share, they are about 75,000.  One time they got to 55,000, and I can bruise, or I worry if I have a nose bleed or am cut shaving, does it start?  Platelets are about the stickiness of blood, right, Lynn?

Lynn Ingram:

Sue may be able to answer that a little better than me.  I'm the chemist in the group, so she's going to do the hematology phase.  

Andrew Schorr:

Okay.  Well, let's go back to you, Susan.  So platelets—and of course that's besides whether the platelets are good platelets, but platelets are supposed to help us coagulate and things like that, right? 

Dr. Leclair:

Right.  And so think of platelets as the, as the cotton gauze that you use when you are putting your hand up against a cut.  They form a web.  They interact—I got to do this, it's the teacher in me—they interact like this.  They form an interlocking web that causes the damaged area to be pulled together so that less blood is being lost.  There's less blood cells getting through that web of interconnection and allows for clotting to happen effectively and efficiently.  

So assuming that they're good—and quality is a different thing than quantity—assuming that your platelets are good, what you want them to do is recognize that there is some place that's damaged, come, form a mat over it, and allow blood clotting to occur. 

Andrew Schorr:

Okay.  So when somebody is bruising, Bill, maybe either they don't have enough platelets, or the platelets aren't top quality, right? 

Dr. Wierda:

Correct.  Or they're on a drug that affects the platelet function, so the platelets aren't working as well or effectively, because the drug is suppressing their function.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.