Absolute Lymphocytes Following Radiation For Prostate Cancer

I had salvage radiation in 2019&again last summer. Went to local hematologist for same issue as you described however my WBC itself has been steady in the 3.0-4.0 with the lymphocytes being the culprit. I am at 0.5 with mine with a normal range showing as 1.0-3.5. The rest of the differential numbers were normal. After consistency and not being acutely sick(except for side effects of Lupron) he did not seem too concerned. Just monitor it. Thinks it is probably side effect of the radiation. You may consider seeing an actual hematologist for it. Hope this helps some.

@hector13 have you consulted a hematologist as @round5 suggested?

With lower than normal white blood cell counts do you have to be more cautious about fighting infection?

My hematologist did not mention anything about being extra careful involving infections. I have continued to live that part of my life unchanged.

I had 43 sessions of Proton Radiation Treatment (PRT) for my advanced aggressive prostate cancer in 2020-2021, along with Lupron for two years. During this time frame my white cells dropped to about 1.6 and my red cells dropped to about 3.1. My Absolute Neutrophils also dropped to 0.5 and Absolute Lymphs dropped to 0.6. After bone marrow biopsy, hematologist diagnosis is that I have a mild case of Myleodysplastic Syndromes (MDS), a form of blood cancer. He feels that it could have been caused by the PRT, but radiation oncologist says that is highly unlikely with PRT. Finger pointing doesn't help matters since I already have whatever I have. My blood numbers have not improved over the 14 months since my last radiation treatment. Hemotologist tried treating blood with 4 months of chemo (Azacitidine) but that had no effect on blood numbers. Currently in a "wait and see" mode of treatment with blood test every couple of months.

I started direct beam radiation for prostate cancer on Feb 17, 2022 and completed the total of 45 treatments on April 27, 2022.

Concurrent with those treatments, I had my annual physical. Blood tests drawn on March 29, 2022 found that my Absolute Lymphocytes had dropped from 1,175 the year before to 429.

I am due for another annual blood test and will report those findings.

As promised, here or the latest results of blood work one year after direct beam radiation treatments for prostate cancer: Absolute Lymphocytes increased from 429 to 648.

Six years ago my prostate was removed, and shortly thereafter I had 40 sessions of radiation that brought my PSA down to 0.00. As expected after radiation treatments, my red and white blood cell count went below the normal range, as did my Absolute Lymphocytes. About a year later, the red and white blood cells returned to normal, but my Absolute Lymphocytes have stayed below the normal range which is 850 - 3900 (cells/uL). My level is around 500-600. None of my doctors seem to have any answers as to how to increase Absolute Lymphocytes. Has anyone else had this issue, and more importantly, been given guidance on how to get it back in the normal range?

Same problem here except my red cells have never returned to normal. We just monitor it and as long as they stay where they are at they are not too concerned and I did see a second doctor(oncologist/hematologist) who told me this. It is my new baseline. I have now started IV chemotherapy since I’ve failed surgery and salvage radiation treatments and they are more concerned about the neutrophils. If they get low that will alter my treatments.

Hi Hector,
I'm sorry to hear that low lymphocytes continue to be an issue for you. You might find this recently published article helpful:
- When to worry about low lymphocytes https://www.cancercenter.com/community/blog/2023/05/when-to-worry-about-low-lymphocytes

What challenges do you face with low lymphocytes? What precautions do you have to take?

18 months later they have recovered to 666, relatively flat to the one year findings.