Expert: Neha Dahiya MD - 10/27/2009

Question
Over the past 3/4 years my wbc has gradually increased. It started at 11.8 in 2005 and in oct 2009 its at 18.5.  I have been tested for leukemia, and test came back negative.  Was told by oncologist, that I had questionable cells, and to keep having cbc's done.  Well, its approx 4 years later...and Im still having tested and every time the WBC is higher and higher, as mentioned its up to 18.5.  All doc have told me I just have a high count. Which that in itself is livable. BUT, if thats the case....1) shouldnt it stay stable instead of increasing everytime? 2) if im just a person who has a high count...why keep getting it tested.  AND....at what level is it going to be a problem?  I know that high wbc levels can also indicate infection, sure I couldnt have an infection brewing for 4 years that the docs cant diagnos?   

other counts as of oct 2009
wbc 18.5
neutrophils 80%
lymphocytes 15%

I only mentions the ones that I have outta range.

Any advice will be great!!
Thanks

Answer
Hello Karin:

The WBC counts are dynamic and change every time you have a CBC done. However they should remain within range if you are otherwise healthy.

at present the 18,500 count is elevated with increase in neutrophils. Such a picture is usually seen in acute infections. As you have pointed out this is not a 4 year long infection.

On the  other hand this is something which is in evolution. At present there isn't anything overtly abnormal as you are otherwise healthy.

One option is to have a bone marrow exam done to look at the morphology (appearance of cells) sinc you mentioned that the oncologist said there are questionable cells. This will form a baseline marrow exam.

If everything is fine just follow up with CBC at regular interval. Either the counts should stabilize at some nominally high range which may be normal for you (provided there are no other health issues). If the counts continue to climb then the bone marrow will reflect specific changes with time to help arrive at a diagnosis.

A high count is a problem when it is accompanied by abnormal cells.
I hope this makes sense to you. You may also consult a hematologist.

Good luck