White Blood Cells:

White blood cells, or leukocytes, are the body's defense system. Your white count rises with infection as your body creates more soldiers to kill the disease. With Hodgkin's it is no different. At one point my white count was 24,000! Normal ranges from 4,500 to 11,000. After my first chemo my count was again over 20,000, but by the second chemo the chemotherapy drugs were winning their own war. When you have chemotherapy your white cells are killed along with the cancer.

Because it is dangerous to kill off too many of your white cells, most doctors have a limit as to how far they will let your white counts fall and still give you treatment. In most cases the white cell count will return to normal after about 3 weeks following treatment (I was amazed how quickly mine rebounded when treatment was complete). It is not unusual for your counts to come up slower and slower as treatment goes on. If your counts are consistently too low, your doctor may give you Neupogen shots to raise your counts.

Some doctors do this with every patient no matter the count. Others, like mine, don't believe in giving this drug unnecessarily. It is very expensive, it can be very painful, and many patients do just fine without it. For other patients this drug is a lifesaver that allows them to have treatments at all. The best advice I have is to talk to your doctor about the pros and cons of Neupogen in your particular case. You must be comfortable with the use or nonuse of the drug.

There are five types of white cells produced by your marrow. These include the following:

Neutrophils: This cell is the most numerous white cell, comprising over 62 percent of them. These are the first to attack an infection, and thus some doctors will count the nuetrophil level as well as the total white count. Neutrophils tend to gather at the site of infection and that area can appear red or feel warm, such as with a fever.

Eosinophils: This cell is the one that reacts to allergies. They are supposed to be our friend because they are supposed to hurt the toxin before it can hurt us.

Basophils: This is the rarest white cell. It is that which releases a histimine, which is what attracts the other white cells to the area. They also produce heparin which dissolves clots (and is used in ports to prevent new clots.).

Lymphocytes: These not only fight infections but also provide immunity to certain disease. Remember all your booster shots as a child? These are the cells they talked to. These cells produce the antibodies that are so important to us.

Monocytes: This last type goes into an area after the infection has been killed and clean up the debris and damage left behind.

What to Do When Your White Count Is Low:

Most people go through treatment and have no problems at all due to their low counts. Others aren't as lucky. If you are worried, the following is some of the best advice you can follow:

    1. Stay away from anyone who is sick. This means cold, flu, infection, whatever. To do this, you really should avoid crowds, as most crowds contain persons who are ill.

    2. Keep your skin clean and dry. Hands collect germs, so wash often with an antibacterial soap. You should also brush your teeth three times a day and be extra careful to do a good job. You are more susceptible to cavities at this time.

    3. Drink plenty of fluids to keep your system cleaned out.

    4. Be very careful with hot water, pans, etc., as your body may not react as quickly as normal to the heat and you may burn yourself. Also, because you might not produce the same signs of infection, keep cuts especially clean and show yoru doctor anything larger than a paper-cut at your visits.

    5.Call your doctor anytime you develop signs of cold or flu. They will probably put you in an antibiotic right away to be safe.

Last updated July 29, 1997.