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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34662
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Hello, I have a low wbc of 2.4, low neutrophil count of 35,

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Hello, I have a low wbc of 2.4, low neutrophil count of 35, high lymphocytes of 55, absolute neutrophil count of 0.9, but my RBC and hgb and hct are normal. Plts are normal too! I have a history of EBV and HPV. Last year my counts were relatively the same yet fairly higher! Is this leukemia??
I am Dr. Arun and will be helping you today.

Did your doctor order peripheral blood smear and bone marrow aspiration?
Were you referred to any specialist?
What are your symptoms?
Customer: replied 4 years ago.
My dr suggested I get a repeat CBC in 2-4 weeks. Just yesterday I woke up with sore throat and sore lymph nodes by throat. I probably just freaking out because I work on a leukemia unit! I made an appointment with a hematologist. No other symptoms. I'm healthy...besides I have a very bad external yeast infection that I've had for 2 years. It can't go away even with all the anti fungal creams and pills.

This is quite unlikely to be leukemia. Bone marrow aspiration establishes the diagnosis of leukemia. Some blasts will be seen in the peripheral smear in patients with acute leukemias. CML is defined by its peripheral WBC count. Typically, leukocytosis is in excess of 100,000/ cubic mm. To diagnose CLL, a lymphocytosis of greater than 5000/ cubic mm must be present. So this is not likely to be leukemia.

Chronic yeast infection often require long-term or prophylactic oral azole therapy for control. So for that, the recommended regimen is fluconazole 150 mg every other day for 3 doses, followed by weekly fluconazole 150-200 mg for 6 months. This regimen abate the symptoms and prevents further recurrence in majority.


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Customer: replied 4 years ago.
Thank you so much u are awesome. One last question and I shall leave you alone. Do you think this could be due to the chronic yeast infection, or due to the EBV or HPV?

You are very welcome.

EBV can be responsible. Virus many times do affect the bone marrow and WBC counts for significant duration. But this is self remitting and would resolve spontaneously.


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