What is the cause of my WBC count to be elevated?

Question

Hello doctor,

I am contemplating whether to book an appointment with an oncologist or not. Last year I had my regular blood work completed by my GP. My WBC was slightly off at 11400/μL, absolute lymphocytes at 3400/μL, and absolute eosinophil count at 600/μL and 36 units per liter ALT (alanine transaminase). After six months, I had another GP appointment and had WBC 15300/ μL, hemoglobin 16.2 g/dL, absolute neutrophils count 9100/μL, absolute lymphocytes 4100/μL, absolute monocytes 1200/μL, absolute eosinophil 800/μL, and ALT 44 units per liter. After the test, I consulted a hematologist or oncologist, and they did further blood tests and said everything seemed normal even though WBC was still elevated. I suppose they were looking for leukemia. I was called for repeat blood tests three months later. However, I do not need to return if they found nothing in my previous tests. Do I need to go in again? I am considering canceling the appointment but looking for input as to why I must redo the test months later. I was not sick then, and no marrow test was needed. Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query, and I can understand your concern.

Your last year's blood reports showed WBC (white blood count) at the borderline. Hence, it is not a concern. But after six months, the reports showed elevated WBC and neutrophilia with lymphocytosis. Apart from myeloproliferative cancers, there are many causes for neutrophilia:

Acute inflammation conditions.
Acute infection.
Rheumatoid arthritis.
Gout.
Post bleeding.
Post-surgery.
Renal disorder.

Hence according to examination, further workup was planned, and according to cause specific treatment can be given. Your liver, spleen, and lymph node palpation should be done as a primary workup as they are enlarged in cancer. You can repeat your CBC (complete blood count), and if your total count is still high, a physical examination and a peripheral smear examination are done. In cancer, WBC is usually more than 50000 x 109/L with hepatosplenomegaly present. Peripheral smear blood examination shows findings in favor of leukemia-like blast.

I hope this information will help you.

Thank you.