Expert Review And References
- Understanding chemotherapy: a guide for patients and families. American Cancer Society. American Cancer Society. American Cancer Society 2013.
- Anemia. American Society of Clinical Oncology . Cancer.Net. Alexandria, VA.: American Society of Clinical Oncology 2009.
- Camp-Sorrell, D. Chemotherapy toxicities and management. Yarbro, CH, Wujcki D, & Holmes Gobel B. . Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett 2011: 17: pp. 458-503.
- Haas ML. Radiation therapy: toxicities and management. Yarbro, CH, Wujcki D, & Holmes Gobel B. . Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett 2011: 14: 312-351.
- Hockenberry MJ, Kline NE. Nursing support of the child with cancer. Pizzo, P. A. & Poplack, D. G. . Principles and Practice of Pediatric Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins 2011: 43:1288-1304.
- Hospital for Sick Children. AboutKidsHealth: Side Effects of Chemotherapy. Toronto, ON: Hospital for Sick Children 2009.
- Panzarella C, Rasco-Baggott C, Comeau, M., et al. Management of disease and treatment-related complications. Baggott, C. R., Kelly, K. P., Fochtman, D. et al. Nursing Care of Children and Adolescents with Cancer. 3rd ed. Philadelphia, PA: W. B. Saunders Company 2002: 11:279-319.
Treatment For A High Rbc Count
If you have erythrocytosis, you may need a regular phlebotomy. This removes a small amount of blood from your body in order to lower your RBC count.
If phlebotomies dont work, your doctor may prescribe hydroxyurea to reduce your RBC count.
You may also need aspirin to help with potential blood clots.
Lifestyle changes can affect your RBC count. Some changes that can help increase your RBC count include:
- maintaining a healthy diet and avoiding vitamin deficiencies
- exercising regularly, which requires the body to use up more oxygen
- avoiding aspirin
If you need to decrease your RBC count, the following lifestyle changes may help:
- reducing the amount of iron and red meat that you consume
- drinking more water
What Are Red Blood Cells
Every second, your bone marrow makes 2-3 million red blood cells. Also called erythrocytes, red blood cells contain the protein hemoglobin that carries oxygen from the lungs to the tissues.Red blood cells are the most common type of cell found in the blood. And its not surprising. The oxygen they carry is essential for cell metabolism.In their mature state, red blood cells are small and biconcave in shape. When they pass through small blood vessels, they transform into a bell-like shape so that they can squeeze through.As red blood cells mature in your bone marrow, they get rid of their nuclei. This extrusion of nuclei by mature red blood cells happens right before they leave the bone marrow. It creates more space for hemoglobin.In people with certain medical conditions, red blood cells have abnormal shapes. For example, in individuals with pernicious anemia, red blood cells appear oval-shaped and in sickle-cell anemia, crescent-shaped.
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What Causes Aplastic Anemia
Aplastic anemia has many causes. Sometimes it occurs for no known reason. Other causes are linked to a previous illness or disorder. Acquired causes may include:
History of certain infectious diseases
History of taking certain medicines, such as antibiotics and anticonvulsants
Exposure to certain toxins, such as heavy metals
Exposure to radiation
History of an autoimmune disease, such as lupus
Aplastic anemia occurs when your bone marrow doesnt make enough red and white blood cells, and platelets. The body’s immune system is confused and begin to attack these critical performing cells.
Is There Anything Else I Need To Know About An Rbc Count
If results showed you had a low or a high red blood cell count, you may need more tests to help make a diagnosis. These include:
- Reticulocyte count, a test that counts the number of reticulocytes in the blood. Reticulocytes are red blood cells that are still developing. These are also known as immature red blood cells.
- Iron tests, which measure iron levels in the blood. Iron is essential for making red blood cells.
- Vitamin B test, which measures the amount of one or more B vitamins in the blood. B vitamins are important for making red blood cells.
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Symptoms That Suggest Cause Of Anemia
Sometimes bone marrow aspiration and biopsy
Laboratory evaluation begins with a complete blood count , including white blood cell and platelet counts, RBC indices and morphology , and examination of the peripheral smear. The reticulocyte count demonstrates how well the bone marrow is compensating for the anemia. Subsequent tests are selected on the basis of these results and on the clinical presentation. Recognition of general diagnostic patterns can expedite the diagnosis .
Other Tests For Evaluation Of Anemia
Serum bilirubin and lactate dehydrogenase can sometimes help differentiate between hemolysis and blood loss both are elevated in hemolysis and normal in blood loss. Other tests, such as vitamin B12 and folate levels and iron and iron binding capacity, are done depending on the suspected cause of anemia. Other tests are discussed under specific anemias and bleeding disorders.
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Treating Abnormal Rbc Levels
Treatment of an abnormal RBC count is typically focused on addressing the underlying condition. These treatments will vary widely depending on the cause.
But if the cause is a nutritional deficiency, medication use, or a chronic condition, there may be things you can do to not only improve your blood count but your overall health too.
The Differential Visualizing The Cells
When performing a differential, a medical technologist looks at the various cells under a microscope. A differential provides information about the relative numbers of each type of WBC. Such information helps the doctor determine whether an illness is caused by a bacteria, a virus, or leukemia. A differential can be used to monitor patients with allergies and to determine how a patient is recovering from an illness or responding to therapy.
In addition to the cell types listed previously, certain cell types that dont normally appear in the blood can be reported in the differential. These cells include promyelocytes, metamyelocytes, blasts, etc. Presence of any of these cells indicates a need for follow-up with your doctor.Finally, the differential can provide information about the appearance of RBCs, since the cells are visualized under a microscope. The appearance of RBCs helps differentiate the various types of anemia.
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Abnormalities In A Full Blood Count
The results of a full blood count are compared to charts that list the normal range of numbers and ratios for each type of blood cell. A result above or below the normal range may indicate an abnormality.Many illnesses, diseases or infections other than the ones listed below can cause an abnormal full blood count result. Abnormalities of the blood sample may include:
- red blood cells and haemoglobin low levels may suggest not enough iron in the diet, blood loss or certain chronic diseases . High levels may suggest polycythaemia vera, kidney disease, chronic lung disease or physiological changes due to living in areas of high altitude
- red blood cell to plasma ratio a lower-than-normal ratio of red blood cells to plasma suggests the person may have anaemia. The opposite finding suggests that the person may be dehydrated or has too many red cells
- white blood cells low levels may suggest the person has a viral infection, bone marrow disease or has been exposed to chemo- or radiotherapy. High levels may suggest bacterial infection, an inflammatory disease or bone marrow disease
- platelets low levels may be the result of taking some medications, viral infection, bone marrow disorders, or an autoimmune disorder. High levels may suggest the presence of a bone marrow disease or an inflammatory condition.
Ask your doctor for further information about these tests.
Can I Take The Test At Home
Most CBC and RBC tests are done in a medical setting, and limited options are available for taking these tests at home.
In some cases, you may be able to take an RBC count with a self-collection test. In this type of test, you use an at-home kit to prick your finger and place a drop of blood on a special test paper. You then mail this blood sample to a laboratory where it can be analyzed, and your results are delivered through a website or smartphone app.
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Full Blood Count Assessment
The full blood count test:
- counts the total number of red cells, white cells and platelets in the sample
- determines the ratio of red cells to plasma
- determines the count of each of the white cell subsets
- works out the average haemoglobin level in the red cells
- measures the average size of the red cells
- if required, reviews the blood cells under a microscope .
What Causes Hemoglobin Levels To Go Low
Several factors affect hemoglobin levels:
- Your body doesnt make enough red blood cells. Your body produces red blood cells and white blood cells in your bone marrow. Sometimes, conditions and diseases affect your bone marrows ability to produce or support enough red blood cells.
- Your body produces enough red blood cells, but the cells are dying faster than your body can replace them.
- Youre losing blood from injury or illness. You lose iron anytime you lose blood. Sometimes, women have low hemoglobin levels when they have their periods. You may also lose blood if you have internal bleeding, such as a bleeding ulcer.
- Your body cant absorb iron, which affects your bodys ability to develop red blood cells.
- Youre not getting enough essential nutrients like iron and vitamins B12 and B9.
What affects red blood cell production?
Your bone marrow produces red blood cells. Diseases, conditions and other factors that affect red blood cell production include:
What affects red blood cell lifespan?
Your bone marrow constantly produces red blood cells. Red blood cells live about 120 days in your bloodstream.
Some factors that affect that lifespan include:
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What Cancers Cause Low Blood Cell Count
- Viral infections that temporarily disrupt the work of bone marrow.
- Certain disorders present at birth that involve diminished bone marrow function.
- Cancer or other diseases that damage bone marrow.
- Autoimmune disorders that destroy white blood cells or bone marrow cells.
What Is The Treatment For Low Red Blood Cells
Treatment for low red blood cells depends on the type of anemia.
For low red blood cells caused by iron deficiency anemia, the first step is to determine the cause of the low iron. If low iron is due to blood loss, such as from stomach ulcers or bowel problems, those issues need to be treated
People with iron deficiency anemia need additional iron. Eating foods high in iron is not sufficient. Iron supplementation may be given:
- Orally as pills or liquid
If iron deficiency anemia is severe, a blood transfusion may be needed.
For some cases of anemia of inflammation, erythropoietin or erythropoiesis-stimulating agents that help the body produce more red blood cells may be used.
Autoimmune hemolytic anemia is treated with:
- Treating the underlying condition such as lupus or CLL
- Cyclophosphamide or rituximab if prednisone does not work well
Treatment for aplastic anemia depends on the cause and may include:
- Stopping medicines that caused the problem
- Never stop taking a prescribed medication without first talking to your doctor
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What Are The Signs And Symptoms Of Anemia
Many people with anemia feel fatigue or muscle weakness. These symptoms can make it harder to cope with other physical and emotional effects of cancer treatment.
Symptoms of anemia may also include:
Rapid or irregular heart beat
Occasional chest pain
Trouble staying warm
Talk with your health care team about any symptoms you experience. This includes any new symptoms or a change in symptoms. Managing anemia and other cancer side effects is an important part of your medical care and treatment. This type of care is called palliative care or supportive care.
How Are Low Blood Counts Diagnosed
A test called the complete blood count is used to determine whether your blood counts are low. The CBC measures the levels of the three basic blood cells: red, white, and platelets.
In the United States, the CBC is typically reported in the format shown below. If your blood counts fall outside of the normal range, which is shown in the Reference interval column, their values will be reported in the Flag column with an L for low and an H for high. The example CBC below shows that white blood cells, red blood cells, and platelets are all low.
|CBC WITH DIFFERENTIAL|
Result column: The result column shows counts that fall within the normal range.
Flag column: The flag column shows counts that are lower or higher than the normal range.
Reference interval column: The reference interval shows the normal range for each measurement for the lab performing the test. Different labs may use different reference intervals.
White blood cells: White blood cells help protect individuals from infections. The above CBC report shows that the patients total white cell count is 1.5, which is lower than the normal range of 4.0-10.5. The low white cell count increases the risk of infection.
Differential: This portion of the CBC shows the counts for the 5 main kinds of white cells, either as percentages , or as the absolute number of cells .
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What Does Mchc Mean In Medical Terms
Doctors use information from the CBC to calculate your MCH. A similar measure to MCH is something doctors call “mean corpuscular hemoglobin concentration” . MCHC checks the average amount of hemoglobin in a group of red blood cells. Your doctor may use both measurements to help in a diagnosis of anemia.
How Is Aplastic Anemia Diagnosed
Your healthcare provider will take your medical history and give you a physical exam. You may also have tests such as:
Blood tests. These may include blood chemistries, evaluation of liver and kidney functions, and genetic studies.
Bone marrow aspiration or biopsy. This involves taking a small amount of bone marrow fluid or solid bone marrow tissue . These are usually taken from the hip bones. They are checked for the number, size, and maturity of blood cells or abnormal cells.
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What Is The Normal Red Blood Cell Count Range
The ability of the red blood cells to carry oxygen depends on the amount of hemoglobin. If the hemoglobin levels are low, the body is required to work a lot harder to supply oxygen to all the body tissues. Low hemoglobin level means the person is anemic and can result in symptoms like fatigue and shortness of breath.
The normal range of RBC is:
Male: 4.7 to 6.1 million cells per microliter
Female: 4.2 to 5.4 million cells per microliter
The normal ranges can differ for different laboratories and also differ depending on the measurements or samples. Usually, ranges given above are common measurements, but doctor should be consulted for the specific test results.
How Is A High Red Blood Cell Count Treated
It depends on the underlying cause. If a health condition is causing a high red blood cell count, your provider may recommend a procedure or medication to lower it.
If you have polycythemia vera , your healthcare provider may prescribe a medicine called hydroxyurea. This will help slow your bodys production of red blood cells. Youll need to see your provider regularly while taking hydroxyurea to be sure your red blood cell level doesnt drop too low. Often, people with polycythemia vera also undergo routine blood withdrawals to keep their red blood cell count under control.
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Red Blood Cell Count: Interpreting Your Test Results
Your blood contains three types of cells: red, white, and platelets. White cells perform functions related to infection control inside the body. Platelets make the blood clot. And red blood cells carry oxygen to the tissues by transporting hemoglobin. Hemoglobin is a protein attached to red cells that picks up oxygen when the cells travel through the lungs and deposits the oxygen in the tissues where needed.
Various types of red blood cell disorders can cause a red blood cell count to be low or high. Anemia often is what causes a low red blood cell count, and rare disorders like red or white cell cancers can cause a high red blood cell count. The red blood cell count normal ranges for adults are:
- Men: 4.5 to 5.9 x 106 per microliter of blood
- Women: 4.1 to 5.1 x 106 per microliter of blood
For children, the reference range of RBCs on lab test results can vary significantly. Your pediatric provider can guide you regarding how to interpret the RBC lab results for your child.
Low Platelet Counts: 7 Ways To Avoid Problems
Follow these tips to help prevent or lessen the effects of low platelet counts:
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