Abnormal Leukocyte Count Research Articles

Total and Differential Leukocyte Counts in Clinically Well Children

To determine whether the total and differential leukocyte count is of value as a case-finding test, we applied the evaluation criteria developed by the US Preventive Services Task Force. The criteria comprise review of the current burden of suffering of the disease to be prevented, the attributes of the intervention to be used, and the quality of the evidence available. A literature search revealed no evidence in the form of data from patients, so a chart review of all complete blood cell counts ordered during a 1-year period by one group of pediatricians was undertaken. At least one value outside of published normal ranges was found on 74.7% of the tests performed on clinically well children. No unsuspected illness was discovered as a result of an abnormal total and differential leukocyte count.

Carbamazepine‐induced pseudolymphoma and immune dysregulation

Pseudolymphoma is a condition that closely resembles malignant lymphoma, both clinically and on histopathological examination. Immunological cell typing is necessary for correct diagnosis. We present here the case of a patient with carbamazepine-induced generalized lymphadenopathy, hepatosplenomegaly, anaemia, abnormal differential leucocyte count, and hypergammaglobulinaemia. There was evidence of severe immune dysregulation. All abnormalities subsided spontaneously after withdrawal of carbamazepine and the patient remained in good health afterwards.

Early diagnosis of neonatal sepsis using a hematologic scoring system

Hematologic findings and published complete blood cell count criteria were evaluated as screening tests for neonatal sepsis. From the data obtained, a hematologic scoring system was formulated that assigns a score of 1 for each of seven findings: abnormal total leukocyte count, abnormal total neutrophil (PMN) count, elevated immature PMN count, elevated immature to total PMN ratio, immature to mature PMN ratio greater than or equal to 0.3, platelet count less than or equal to 150,000/mm3, and pronounced degenerative changes in PMNs. There were 298 evaluations for sepsis (243 in the first 24 hours of life and 55 between days 2 and 30). Twenty-six of 27 (96%) infants with sepsis and all 23 infants with probable infection had scores greater than or equal to 3, compared with 35 of 248 (14%) noninfected infants. The likelihood of sepsis with score greater than or equal to 3 was 31%, and this value differed with both gestational and postnatal ages (34% vs 8% in preterm and term infants less than 24 hours of age, and 65% thereafter). The higher the score the greater was the likelihood of sepsis. With score less than or equal to 2 the likelihood that sepsis was absent was 99%. The hematologic scoring system should improve the diagnostic accuracy of the complete blood cell count as a screening test for sepsis and could simplify and standardize the interpretation of this global test.

T-cell subsets in multiple myeloma. Impact of cytostatic treatment.

Blood leukocyte and lymphocyte counts, absolute and relative numbers of T-lymphocytes and T-cell subsets were studied in 45 patients with multiple myeloma and 18 healthy controls. No differences were found between untreated patients and controls. In the group of untreated patients similar results were obtained in patients with low-intermediate tumour cell mass as in patients with large tumour cell mass. In patients with large tumour cell mass studied during cytostatic therapy, leukocyte and lymphocyte counts, T-cells, OKT4+ cells and OKT4/OKT8 ratios were significantly lower than in untreated patients. Patients studied at varying intervals (2-28 mo.) after cessation of therapy still exhibited abnormal leukocyte and lymphocyte counts, numbers of T-cells, OKT4+ cells and OKT4/OKT8 ratios.

Infections in hypothermic infants younger than 3 months old.

Hypothermia in infants is associated with considerable morbidity and mortality. Infection is thought to occur frequently and to carry a poor prognosis in infants with hypothermia. The medical records of 51 infants less than 3 months of age hospitalized from 1976 through 1981 with rectal temperatures of 34 degrees C or less were reviewed. Infections were diagnosed in 27 of the 51 infants. Infections were associated significantly with the presence of bradycardia, anemia, abnormal leukocyte counts, abnormal serum glucose levels, and uremia, especially if two or more of these variables were present. Morbidity and mortality were higher among infected than among noninfected infants. No rapid reliable indicators for the presence or absence of infection in an individual infant with hypothermia were found despite the differences noted between the two groups. Until new techniques for the detection of bacterial infections became available, we suggest that antibiotics be given to all infants younger than 3 months of age with hypothermia on admission to the hospital.

Increased levels of myeloid progenitor cells in the blood of patients with metastatic invasion of the marrow.

Granulocyte-macrophage clusters and colony-forming cells (CFU-C) in the peripheral blood have been studied in 26 cancer patients with neoplastic bone marrow involvement. The concentration of CFU-C in the blood of normal individuals and of cancer patients with no bone marrow invasion, ranged from 0 to 99 ml. In contrast, out of 27 cancer patients with marrow invasion, 9 (35%) showed a significant increase of blood CFU-C (100 to 21000/ml) and of those 5 (19%) showed an increase of blood colonies (41 to 9000/ml). There was a strong correlation between increased CFU-C or colony concentration and the presence of myeloid or/and erythroid immature cells in the peripheral blood. On the other hand, there was no apparent correlation between an increased CFU-C level and anaemia or abnormal blood leucocyte count or marrow fibrosis. These observations suggest that bone marrow involvement by neoplastic cells may cause spatial redistribution of the granulocyte macrophage progenitor cells.

The value of the leucocyte count in the diagnosis of acute appendicitis.

Total and differential leucocyte counts were performed on 175 patients with a provisional diagnosis of acute appendicitis. Ninety-six per cent of patients with acute appendicitis had either an abnormal total or differential leucocyte count. Four of 24 patients operated on with a normal leucocyte count had acute appendicitis. It is concluded that leucocytosis of above 10 000/mm3 or a differential in excess of 75% neutrophils supports the clinical diagnosis of acute appendicitis and that routine estimation of the leucocyte count is a useful investigation. While a normal leucocyte count does not exclude even a perforated appendicitis, such a count should prompt further review of the diagnosis, especially in the presence of an atypical history or minimal physical signs.

Significance of haematological parameters in the non-Hodgkin's malignant lymphomas.

Blood findings at diagnosis, in 140 adults with lymphoma, were correlated with bone marrow involvement and survival. An abnormal haemoglobin, leucocyte count or platelet count was found in 57% of patients. Lymphocytopenia occurred in 46%. All patients with thrombocytopenia or neutropenia, 69% with leucopenia and 63% with anaemia had marrow involvement with lymphoma. Marrow involvement in histiocytic and stem cell lymphoma was always associated with anaemia. Marrow involvement in poorly differentiated lymphocytic lymphoma (PDL) was associated with anaemia, thrombocytopenia, leucopenia, lymphocytopenia or lymphoma cells in the blood in 93% of patients. Bone marrow involvement was found in only 13% of patients with normal haematological parameters. In the absence of marrow involvement blood abnormalities at diagnosis did not generally correlate with survival. However, among patients with diffuse PDL who had marrow involvement, anaemia, thrombocytopenia and leucopenia adversely affected survival. Lymphocytopenia did not correlate with survival.

A CASE OF POLYCYTHEMIA RUBRA VERA WITH LEUKEMIC BLOOD PICTURE

When, in 1904, Turk 1 first noted the abnormal leukocyte counts that may appear in polycythemia, he did not seem particularly interested in the blood smear. On the other hand, Blumenthal, 2 during the following year, thought that he had discovered a new disease when he observed a leukocytosis with many myelocytes in a case of polycythemia. This condition is now well recognized and has been described by Weber, 3 Pendergrass and Pancoast, 4 Minot and Buckman 5 and others. The case presented here is reported not only because it comes in this group, but also because the patient was under observation for almost two years before abnormal cells were seen. It was three years before the leukemic pictures became marked. In addition to the blood picture, the enlarged spleen is of interest. Most unfortunately a postmortem examination could not be obtained. The patient was in the Presbyterian Hospital on