Monitoring Blood 101

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A reduced number of blood cells in circulation is a common side effect of

chemotherapy. Blood consists of three basic blood cell types: red blood cells,

white blood cells, and platelets. Blood cells are produced from specialized

cells in the bone marrow and are regularly released into the circulatory system.

Chemotherapy destroys cells that divide rapidly, a characteristic of cancer

cells. However, bone marrow cells also divide rapidly and are frequently damaged

by chemotherapy. As a result, blood counts may fall. Low blood counts may be

treated by administering blood cell growth factors. In some circumstances, blood

transfusions may also be necessary.

What are the symptoms of low blood counts?

Your symptoms will depend on which types of blood cells are low. Common symptoms

of the different types of low blood cell counts are listed below.

Low red cells cause fatigue, trouble breathing, rapid heart rate, difficulty

staying warm, pale skin, dizziness, and lightheadness. Low white cells cause

infection and fever. Low Platelets cause excessive bruising and bleeding. A

unit of whole blood does not usually have very many platelets. If you need a

transfusion of platelets, you might receive a combination of platelets from

different donors.

It is important to monitor for low blood cell counts because this condition may:

a.. Increase your risk of unpleasant and sometimes life-threatening side

effects, such as fatigue, infection, and/or bleeding.

b.. Disrupt delivery of your cancer treatment, resulting in a change to the

planned dose and time.

c..

Blood counts are monitored with a laboratory test called a complete blood

count (CBC).

What are the treatments for low blood counts?

Low blood counts may be treated with blood cell growth factors, which were

originally discovered as substances naturally produced by the body. These

factors stimulate the cells in the bone marrow to produce more red blood cells,

white blood cells, or platelets. Certain laboratory-produced blood cell growth

factors are approved by the U.S. Food and Drug Administration (FDA) for the

treatment of cancer patients with low blood counts.

Low red blood cell counts - Erythropoietin is a blood cell growth factor that

selectively increases production of red blood cells. Clinical trials have

demonstrated that erythropoietin is effective in increasing the number of red

blood cells in cancer patients undergoing chemotherapy. It acts gradually, over

a period of weeks.

Blood Transfusions: Blood transfusions can cause some minor complications, such

as fever and allergic reactions. In very rare cases, they can lead to more

dangerous reactions. To minimize the risk of these complications, blood banks

have developed many safeguards to make sure that blood is only collected from

healthy donors. They test all donated blood to make sure that it cannot pass on

a virus or anything else that could make the recipient ill. Although blood

transfusions are generally safe, doctors try to use them only when absolutely

necessary in case they lead to a complication. Several techniques are available,

including special surgical approaches, to minimize a patient's need for a blood

transfusion. If you don't have enough red blood cells, your bloodstream will

carry less oxygen throughout your body. This condition is known as anemia.

Anemia can make you feel weak, tired, lightheaded, or dizzy.

Bone marrow, the soft spongy center of some of your bones, makes all of your red

blood cells. Your kidneys keep track of the number of red blood cells in your

body. When the kidneys detect that you don't have enough red blood cells, they

release the hormone erythropoietin. Hormones are chemical substances that are

formed in one part of the body that affect another part of the body.

Certain white blood cells called neutrophils and monocytes can move from the

blood into the tissues. Once they are in the tissues, these cells ingest, or

eat, invading bacteria (organisms that can cause infections and disease) and

fungi (plantlike organisms, such as yeasts and molds, that can cause

infections), which helps cure the infection.

If you have very low white blood cell counts and a serious infection, you might

receive a transfusion of granulocytes, a type of white blood cell. You might be

given granulocytes that have been collected by apheresis, a special process that

removes only the granulocytes from the donor's blood and returns all of the

other blood components to the donor's body. Alternatively, you might be given

something called " buffy coat, " which is made up of granulocytes that have been

separated from a unit of whole blood.

More below, use as a refresher, but interesting material for the newcomer as

well, referring to treatments for low red and white counts and platelets:

http://www.caring4cancer.com/go/cancer/treatment/chemotherapy/understanding-and-\

monitoring-your-blood-counts.htm

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J. Feldman, MD

Professor of Medicine

Director, Hematological Malignancies

Weill Cornell Medical College

New York-Presbyterian Hospital

New York, NY

DATE: Tuesday, May 19, 2009

TIME: 12:00 PM to 1:00 PM (eastern time)

TO REGISTER:

Call: (866) 992-9950, ext 302

?? Go to: www.LLS.org/CMLLINKS

or www.LLS.org/leukemiaeducation

FYI,

Lottie