Case study (16)- Chemotherapy-induced leukopenia.
History and clinical signs and symptoms
A 45-year-old woman with Hodgkin’s disease was treated with chemotherapy.
The patient was regularly sampled to monitor her status.
Laboratory Investigations:
1. Hematologic findings
RBC: 4.13 X 106/μL (4-5.5 X 106/μL)
HGB: 120 g/dL (120-174 g/dL)
HCT: 39.3 % (36-52%)
MCV: 95.3 fL (76–96 fL)
MCH: 39.1 pg (27-32 pg)
MCHC: 305 g/L (300-350 g/L)
RDWsd:44.6 fL (20-42 fL)
RDWcv: 14.9 % (0-16 %)
WBC: 1.69 X103/ μL (5–10 X 103/ μL)
Neutrophils: 0.89 X 103/μL (2-7.5 X 103/μL)
Lymphocytes: 0.62 X 103/μL (1.08–3.17 X 103/μL)
Monocytes: 0.09 X 103/μL (0.15-0.7 X 103/μL)
Eosinophils: 0.06 X 103/μL (0-0.5 X 103/μL)
Basophils: 0.03 X 103/μL (0-0.15 X 103/μL)
Neutrophils %: 52.7 % (40-75 %)
Lymphocytes %: 36.8 % (14.76-45.4 %)
Monocytes %: 5.4 % (3-7 %)
Eosinophils %: 3.4 % (0-5 %)
Basophils %: 1.7 % (0-1.5 %)
PLT: 233 X 103/μL (150-400 X 103/μL)
Interpretive Flags Leucopenia ?, neutropenia ? Lymphopenia ?.
Interpretation
The WBC differential and BAS scattergrams are clearly defined. The WBC differential subpopulations are well characterized.
Of note, the WBC counts including neutrophil and lymphocyte counts were well below the lower limit of the normal reference range (see also interpretative flags “leukopenia”, „neutropenia” and “lymphopenia”).
The RBC and PLT histograms are clearly separated and have a normal shape and size. The HGB, RBC, and PLT counts are also within the normal range.
Peripheral blood smear
The number of leukocytes in the peripheral blood smear was extremely low; the observed leukocytes are apparently normal.
2. Other laboratory findings
- Other laboratory findings including inflammatory markers such as acute phase reactants were not remarkable.
Diagnosis
Chemotherapy-induced leukopenia.
Disease course
- Chemotherapy was suspended. Leukocyte counts increased within 10 days.
- Chemotherapy-induced leukopenia. History and clinical signs and symptoms A 45-year-old woman with Hodgkin’s disease wa…){kind=link}
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