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What Do Red and White Blood Cell Counts Mean

  • Synopsis: Published: 2013-08-25 (Rev. 2017-04-06) - Article provides information regarding red and white blood cell count used to identify diseases and to monitor human health problems. For further information pertaining to this article contact: Thomas C. Weiss at Disabled World.
Blood Cell Count

The cells that circulate in the bloodstream are generally divided into three types: white blood cells (leukocytes), red blood cells (erythrocytes), and platelets (thrombocytes). A complete blood count (CBC), also known as full blood count (FBC) or full blood exam (FBE) or blood panel, is a test panel requested by a doctor or other medical professional that gives information about the cells in a patient's blood. A scientist or lab technician performs the requested testing and provides the requesting medical professional with the results of the CBC. Abnormally high or low counts may indicate the presence of many forms of disease, and hence blood counts are amongst the most commonly performed blood tests in medicine, as they can provide an overview of a patient's general health status.

Main Document

Quote: "White blood cells contain the immune cells that attack and remove viruses and bacteria in a person's body."

Blood counts may be used to identify diseases and to monitor a person's health. Though the various tests related to blood counts cannot diagnose lymphoma on their own, they can alert a doctor to an issue in a person's body and prompt a doctor to perform appropriate tests. Since the majority of chemotherapy regimens, for example, result in low blood counts in a person, the tests become very important in monitoring a person's health after a diagnosis has been achieved.

Blood tests are used to both measure and inspect a person's red blood cells, white blood cells, and platelets. A, 'Complete Blood Count (CBC),' tests all three cell types. The test only requires a few drops of a person's blood. Nearly all cell counting is done by machine, although hematology technicians examine a person's blood cells under a microscope as well to make sure there are no abnormalities in size or shape.

Red Blood Cells (RBC): Red blood cells carry oxygen from a person's lungs to the rest of their body. A depletion of red blood cells may lead to anemia. Anemia results in dizziness, fatigue, or even more serious symptoms if it is remains untreated. Typical red blood cell count (RBC) levels are:

  • 4.2 to 5.4 million cells per micro-liter for women
  • 2.6 to 4.8 million cells per micro-liter for children
  • 4.5 to 6.2 million cells per micro-liter of blood for men

Hematocrit: The amount of RBC's is also show through a person's, 'Hemacrit,' which is a ratio of the number of RBC's to the volume of blood. Common values are:

  • 42%-52% in men
  • 37%-47% in women
  • 36%-40% in children

Hemoglobin: Hemoglobin is a molecule on a RBC that allows it to carry oxygen. Low hemoglobin counts may also result in fatigue and anemia. Typical levels are:

  • 13-18 grams per deciliter in men
  • 12-16 grams per deciliter in women
  • 11 to 13 grams per deciliter in children

White Blood Cell Count (WBC)

White blood cells contain the immune cells that attack and remove viruses and bacteria in a person's body. Low WBC counts may indicate that a person is in danger of infection. High WBC counts might indicate an existing infection, tissue damage, or leukemia. Typical levels are 4,000-10,800 cells per micro-liter of a person's blood. There are a number of different types of WBC's and their values differ; they are:

  • Monocytes (2%-9% of all WBCs)
  • Eosinophils (1%-4% of all WBCs)
  • Basophils (0.5%-2% of all WBCs)
  • Absolute Neutrophil Count (ANC)
  • Neutrophils (50%-60% of all WBCs)
  • Lymphocytes (20%-40% of all WBCs)

Neutrophils are a person's body's first line of defense against infection and disease. These cells assist with inflammation as a result of cuts or bacteria in the skin and are responsible for pus. A low level of neutrophils referred to as, 'neutropenia,' leaves a person susceptible to disease. Smoking and obesity increase a person's neutrophil count; for each pack of cigarettes a person smokes each day, their granulocyte count may increase.

Lymphocytes: T-cells and B-cells are lymphocytes. Depletion of these levels may also increase a person's risk of experiencing an infection. Typical levels are:

  • 1500 cells per microliter of blood for adults
  • 3000 cells per microliter of blood for children

Platelet Count: Platelets are responsible for blood clotting. Typical levels are 133,000-333,000 platelets per microliter of a person's blood. If the level decreases to below 30,000 referred to as, 'thrombocytopenia,' abnormal bleeding may happen. Counts below 5,000 are considered to be life-threatening.

The Meaning of Blood Counts

Chart showing Blood Count Types
About This Image: Chart showing Blood Count Types
What do blood counts mean? In an attempt to understand blood counts, the following items will be presented:

  • Blood smear
  • Karyotype Test
  • Flow Cytometry
  • Blood chemistry
  • Immunophenotyping
  • White cell differential
  • Polymerase Chain Reaction
  • Fluorescence in Situ Hybridization (FISH)

Blood Smear

A doctor might order a blood smear, also referred to as a, 'peripheral blood smear,' or, 'manual differential,' if a person's Complete Blood Count (CBC) results are unclear or abnormal, or if the doctor thinks a disease or disorder might be disrupting the person's normal blood cell production. The test helps to determine whether red cells, white cells and platelets are average in appearance and number. It is also used to determine the proportion of each type of white cell relative to the person's total white cell count. The results also help a doctor to monitor cell production and cell maturity before and during blood cancer therapy.

A blood smear is performed using a single drop of a person's blood. The blood is spread on a glass slide, dried and then stained with a dye. The sample is examined under a microscope to calculate the number of each type of blood cell. A doctor also compares the shape, size and general appearance of the sampled cells to average ones. As for the results of a blood smear - the test may show the presence of immature or abnormal cells, which may indicate an underlying condition or provide information about its severity and suggest the need for additional testing.

Karyotype Test

A, 'karotype,' test both identifies and evaluates changes to the expected chromosome arrangement, shape, size and number in a sample of a person's blood or bone marrow cells. The test provides a map of the 46 human chromosomes of a cell. In some instances a dye called, 'Giemsa,' might be used as a stain to make the banding pattern of chromosome pairs easier to see. The process is also referred to as, 'G-banding,' and the finding may assist a doctor to develop a more specific treatment plan.

Flow Cytometry

Flow cytometry analyzes a person's blood or bone marrow cells with the goal of finding out whether a high white cell count is the result of blood cancer. The test involves identifying cells as they flow through an instrument called a, 'flow cytometer.' Flow cytometry measures the number and percentage of cells in a person's blood sample and cell characteristics such as shape, size, and the presence of biomarkers on the cell surface. The method helps to sub-classify cell types to a person's doctor can decide on the best treatment plan for them. Flow cytometry can also detect residual levels of disease after treatment, helping the person's doctor to identify disease relapse and restart treatment as needed.

Blood Chemistry

Chart showing things Blood Chemistry tests measure
About This Image: Chart showing things Blood Chemistry tests measure
A person's blood chemistry is examined using a group of tests referred to as, 'chemistry panels.' The tests provide information concerning a person's general health. Depending upon the type of panel, the tests can measure:

  • Protein
  • Minerals
  • Vitamins
  • Hormones
  • Cholesterol
  • Blood glucose
  • Electrolyte balance
  • Antibodies, including those developed from vaccinations
  • Chemical substances that indicate liver and kidney function

A person is asked to fast before the test is performed. After their blood is drawn it is placed in a tube or tubes and often times left to clot. The fluid portion of the person's blood that remains after clotting called the, 'serum,' is used for various chemical studies. The results provide a doctor with information concerning a person's overall health and identify potential issues that might require treatment. Higher levels of certain blood proteins may be signs of disease severity. High levels of uric acid may sometimes indicate disease.

Immunophenotyping

Immunophenotyping identifies a particular type of cell in a sample of a person's blood, lymph node cells, or bone marrow. The procedure may be important in helping to choose the best treatment for the person. For example; immunophenotyping may distinguish myeloid leukemic cells from lymphocytic leukemic cells, average lymphocytes from leukemic lymphocytes, and B-cell lymphocytes from T-cell lymphocytes. Immunophenotyping also shows whether a person's cells are, 'monoclonal,' or derived from a single malignant cell.

White Cell Differential

A white cell differential, also referred to as a, 'CBC plus differential,' or a, 'differential,' measures the amount of the different kinds of white cells in a person's blood. A white cell differential is many times included as part of the CBC. The test helps to determine a person's body's ability to react to and fight infections. It may also identify various types and stages of blood cancers, detect the existence and severity of infections, and measure a person's response to chemotherapy. The absolute neutrophil count (ANC) is the number of neutrophils - a type of white cell, in a person's blood that will fight infections.

After a person's blood is drawn it is placed on a stained blood slide and examined. A pathologist determines the percentage of different types of white cells present. Abnormal patterns of white cells might point to infections, immune disorders, leukemia, inflammation and other issues.

Polymerase Chain Reaction

Polymerase chain reaction (PCR) is an extra-sensitive test, one that measures the presence of certain biomarkers in a person's blood or bone marrow. It measures any remaining blood cancer cells not found by cytogenetic methods such as FISH (explained below). PCR is used to diagnose and check a person's molecular response to treatment. PCR can detect a specific DNA abnormality or marker found in people with certain blood cancers such as chronic myeloid leukemia and acute promyelocytic leukemia. PCR allows more sensitive follow-up of people who are in remission and can help determine whether a person needs additional treatment.

Fluorescence in Situ Hybridization (FISH)

Fluorescence in situ hybridization (FISH) is a lab test performed on a person's blood or bone marrow cells to detect chromosome changes in blood cancer cells. FISH helps to identify genetic abnormalities that might not be evident with an examination of cells under a microscope, something that helps to ensure that a person receives appropriate treatment. After treatment starts, doctors use FISH around every 3-6 months to determine whether therapy is working.

Fluorescence in situ hybridization (FISH) is a lab test performed on your blood or bone marrow cells to detect chromosome changes (cytogenetic analysis) in blood cancer cells. FISH helps identify genetic abnormalities that may not be evident with an examination of cells under a microscope. This helps ensure that the proper treatment is used. Once treatment begins, doctors use FISH - usually every three to six months - to determine whether therapy is working.

In Summary:

Note: Causes shown below are just some of the possible causes for a high/low count. Work with your doctor for an accurate diagnosis.

What does a high red blood cell count mean

A high red blood cell count (a condition called polycythemia), indicates an excess of red blood cells circulating in your bloodstream. Red blood cells (erythrocytes, or RBCs) are produced in your bone marrow and transport oxygen from your lungs to tissues throughout your body. A high red blood cell count is also called erythrocytosis (uh-rith-roh-sie-TOH-sis). A high red blood cell count means your body is producing too many red cells and is symptom, not a disease in of itself.

What does a low red blood cell count mean

If the RBC count is low (anemia), the body may not be getting the oxygen it needs. A low RBC count may indicate bleeding, kidney disease, bone marrow failure (for instance, from radiation or a tumor), malnutrition, or other causes. A low count may also indicate nutritional deficiencies of iron, folate, vitamin B12, and vitamin B6.

What does a high white blood cell count mean

When a high white cell count is present, infection is usually the first cause that's considered and your doctor may follow up by ordering a differential count. This reveals the quantity of each type of white blood cell present which can give a clue as to the kind of infection that's present. For example, eosinophil counts go up with parasitic infections as well as with allergic disorders. Medications can also be a cause of a high white blood count.

What does a low white blood cell count mean

Low white cell counts are associated with chemotherapy, radiation therapy, leukemia (as malignant cells overwhelm the bone marrow), myelofibrosis and aplastic anemia (failure of white and red cell creation, along with poor platelet production). In addition, many common medications can cause leukopenia (eg. minocyclen, a commonly prescribed antibiotic). There are also reports of Leukopenia caused by Depakote (Divalproex Sodium or Valproic Acid), a drug used for epilepsy (seizures), mania (with bipolar disorder) and migraine.

Awareness: Sickle Cell Awareness

The month of September is Sickle Cell Awareness Month. Sickle cell disease is an inherited disease that affects the red blood cells. Sickle Cell disease predominately affects the African-American community and research shows that blood donors with the same ethnic background provide the best match to those with the disease.

Facts: Blood Cell

  • Blood makes up around 7% of the weight of a human body.
  • There are 150 Billion red blood cells in one ounce of blood.
  • Blood cells are being made and replaced constantly, based on their lifespan. Most blood cells are made in the bone marrow.
  • There are currently around 30 recognized blood types (blood groups). You might be familiar with the more simplified ABO system which categorizes blood types under O, A, B and AB.
  • Platelets are colorless cells whose main function is to control bleeding. They make up less than 1% of your blood.
  • Red blood cells are full of haemoglobin. They live for 120 days before they are destroyed in your spleen, but they are constantly being replaced.
  • White blood cells are an important part of the body's immune system. They defend against certain bacteria, viruses, cancer cells, infectious diseases and other unwanted materials.
  • Blood is made up of 3 types of blood cells, red blood cells, white blood cells, and platelets, and plasma.
  • Plasma is a pale yellow mixture of water, proteins and salts. One of the functions of plasma is to act as a carrier for blood cells, nutrients, enzymes and hormones.
  • It takes 20 to 60 seconds for a drop of blood to travel from your heart, through your body, and back to the heart again.

Related Information:

  1. Disabled World (Sep 28, 2012). Blood Type Chart: Facts and Information on Blood Group Types
    https://www.disabled-world.com/calculators-charts/blood-chart.php
  2. Disabled World (Feb 20, 2008) . Blood pressure chart showing high low and average blood pressure for adults.
    https://www.disabled-world.com/artman/publish/bloodpressurechart.shtml
  3. Disabled World (Aug 21, 2013). Female Health Check Up - Things Women Should Have Checked in Medical Exams
    https://www.disabled-world.com/health/female/female-check-up.php




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