Low white blood cell count: Can cancer treatment cause leukopenia?

Posted by round5 @round5, Sep 1, 2021

Can Lupron/Eligard and radiation for prostate cancer cause leukopenia? My WBC is now 2.5. My lymphocytes are just 290.

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Hi @round5 Unfortunately the radiation portion of your treatment can cause a significant decrease in your WBC. The Lupron and Elegard are more hormonal based so they’re most likely not the culprits.
https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20046192
With your counts low, you’ll want to be very cautious for the next few months while your WBC returns to normal, about 3 months or so. When your WBC is low your immune system is compromised so when you’re out in public you’ll definitely want to follow Covid protocol by wearing a mask, washing/sanitizing hands frequently, avoiding crowds…the usual.

I’m so sorry you’re having to deal with all of that business. I’m female so that’s not in my future but my husband and I have friends who are coping with similar issues. How are you doing with the medications and side effects of the treatment?

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@loribmt

Hi @round5 Unfortunately the radiation portion of your treatment can cause a significant decrease in your WBC. The Lupron and Elegard are more hormonal based so they’re most likely not the culprits.
https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20046192
With your counts low, you’ll want to be very cautious for the next few months while your WBC returns to normal, about 3 months or so. When your WBC is low your immune system is compromised so when you’re out in public you’ll definitely want to follow Covid protocol by wearing a mask, washing/sanitizing hands frequently, avoiding crowds…the usual.

I’m so sorry you’re having to deal with all of that business. I’m female so that’s not in my future but my husband and I have friends who are coping with similar issues. How are you doing with the medications and side effects of the treatment?

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Thanks for your reply. I too thought the radiation was the culprit but when I emailed my care team they said not. They never ordered a CBC anytime. I had this done when I got home and when I informed them of the results they said I needed to follow up with my provider here 🤷‍♀️because the radiation wouldn’t cause it.

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@round5

Thanks for your reply. I too thought the radiation was the culprit but when I emailed my care team they said not. They never ordered a CBC anytime. I had this done when I got home and when I informed them of the results they said I needed to follow up with my provider here 🤷‍♀️because the radiation wouldn’t cause it.

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The care team answer was interesting because radiation can cause an impact on blood counts. But maybe because your treatment was confined to a targeted area it limited exposure to surrounding tissue and didn’t impact the body. If that’s the case, that’s a plus. But it still doesn’t answer why you’re having the decline in white blood cells.

Were the RBC numbers good?
Did you have a CBC before starting your treatments?

Do you have any symptoms of an infection, any autoimmune diseases, viruses? Are you on any other medications besides the Elegard and Lupron, such as antibiotics?

In any case, this does warrant further investigation. Have you talked your PCP after receiving the results?

REPLY
@loribmt

The care team answer was interesting because radiation can cause an impact on blood counts. But maybe because your treatment was confined to a targeted area it limited exposure to surrounding tissue and didn’t impact the body. If that’s the case, that’s a plus. But it still doesn’t answer why you’re having the decline in white blood cells.

Were the RBC numbers good?
Did you have a CBC before starting your treatments?

Do you have any symptoms of an infection, any autoimmune diseases, viruses? Are you on any other medications besides the Elegard and Lupron, such as antibiotics?

In any case, this does warrant further investigation. Have you talked your PCP after receiving the results?

Jump to this post

RBC 3.87
Hgb.12.5
Platelets are WNL
These are consistent numbers for last couple of years.
No I did not have a CBC done prior to treatment,only PSA and liver function was ordered. WBC 1 year ago was 3.5. I have no symptoms of any infection,I am not on any antibiotics,just fatigue which is an ongoing thing which I attribute to the medical castration. My PCP referred me back to Mayo which is now referring me back to my PCP🤷‍♀️

REPLY
@round5

RBC 3.87
Hgb.12.5
Platelets are WNL
These are consistent numbers for last couple of years.
No I did not have a CBC done prior to treatment,only PSA and liver function was ordered. WBC 1 year ago was 3.5. I have no symptoms of any infection,I am not on any antibiotics,just fatigue which is an ongoing thing which I attribute to the medical castration. My PCP referred me back to Mayo which is now referring me back to my PCP🤷‍♀️

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Oh that’s just frustrating when there’s no definitive answer and you’re feeling like a yoyo!

Our bloodwork can really vary on a daily/weekly basis, often presenting some interesting puzzles. Last summer, after several months of finally having my labs look relatively normal during weekly blood tests, my WBC took a nose dive while my LDH shot up, indicating I must have some raging event going on inside! But I had no fever and no indication of any infection. With the results of the blood work, I should horribly ill! I felt perfectly healthy and energetic so the test results where a real mystery!

I had twice weekly blood tests then to keep an eye on things. Finally after week 3 of getting worse and dropping to a dangerous neutropenic level, it prompted a trip back to Mayo for a bone marrow biopsy. My doctor fearing the leukemia returned. Thankfully the biopsy was clean and within 2 weeks after that the bloodwork mysteriously returned to normal. In my case, though we can’t prove it, my doctor felt it was my new immune system fighting some re-emerging cancer cells called Graft vs Leukemia. Which is why I had the transplant…to do just that!! It’s rare to have caught it happening. But it just shows what can be going on inside when we’re not even aware it’s happening.

Just thinking out loud, wondering if your meds could be causing the immune system to be reacting to your shrinking prostate and the procedure you’ve had. There is a change in your body chemistry and the tissue. With the shrinking tissue those cells are cast off into the blood. So you could see an elevation in macrophages/monocytes that would be cleaning up the dead tissue cells. LDH-lactate dehydrogenase is used as a tool to indicate and measure tissue damage. On your CBC panel do you see a LDH number? And how about a SED rate which will show inflammation?

Well, you’re scratching your head along with your doctors on this one. Hopefully you’ll get to the bottom of this soon. They may opt to do a wait and see while having more frequent blood tests every few weeks or so.

When is your next visit to your next CBC?

REPLY
@loribmt

Oh that’s just frustrating when there’s no definitive answer and you’re feeling like a yoyo!

Our bloodwork can really vary on a daily/weekly basis, often presenting some interesting puzzles. Last summer, after several months of finally having my labs look relatively normal during weekly blood tests, my WBC took a nose dive while my LDH shot up, indicating I must have some raging event going on inside! But I had no fever and no indication of any infection. With the results of the blood work, I should horribly ill! I felt perfectly healthy and energetic so the test results where a real mystery!

I had twice weekly blood tests then to keep an eye on things. Finally after week 3 of getting worse and dropping to a dangerous neutropenic level, it prompted a trip back to Mayo for a bone marrow biopsy. My doctor fearing the leukemia returned. Thankfully the biopsy was clean and within 2 weeks after that the bloodwork mysteriously returned to normal. In my case, though we can’t prove it, my doctor felt it was my new immune system fighting some re-emerging cancer cells called Graft vs Leukemia. Which is why I had the transplant…to do just that!! It’s rare to have caught it happening. But it just shows what can be going on inside when we’re not even aware it’s happening.

Just thinking out loud, wondering if your meds could be causing the immune system to be reacting to your shrinking prostate and the procedure you’ve had. There is a change in your body chemistry and the tissue. With the shrinking tissue those cells are cast off into the blood. So you could see an elevation in macrophages/monocytes that would be cleaning up the dead tissue cells. LDH-lactate dehydrogenase is used as a tool to indicate and measure tissue damage. On your CBC panel do you see a LDH number? And how about a SED rate which will show inflammation?

Well, you’re scratching your head along with your doctors on this one. Hopefully you’ll get to the bottom of this soon. They may opt to do a wait and see while having more frequent blood tests every few weeks or so.

When is your next visit to your next CBC?

Jump to this post

Interesting process for sure. I see no sed rate or LDH on my CBC. I have no prostate,was having salvage radiation for second time. I just scheduled a CBC and appointment with local hematologist oncologist here in Southern Illinois for October 5th. CBC before the appointment. 👍.

REPLY
@round5

Interesting process for sure. I see no sed rate or LDH on my CBC. I have no prostate,was having salvage radiation for second time. I just scheduled a CBC and appointment with local hematologist oncologist here in Southern Illinois for October 5th. CBC before the appointment. 👍.

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Our bodies are certainly complex! Can you imagine the complete owner’s manual? LOL
It will be interesting to see what the bloodwork shows in October. Hopefully things have returned to normal by that time. But it will give you some peace of mind to check with the hematologist/oncologist just to make sure everything is ok.
I’d like to know how this all turns out for you. Will you report back with a follow up?

REPLY
@loribmt

Our bodies are certainly complex! Can you imagine the complete owner’s manual? LOL
It will be interesting to see what the bloodwork shows in October. Hopefully things have returned to normal by that time. But it will give you some peace of mind to check with the hematologist/oncologist just to make sure everything is ok.
I’d like to know how this all turns out for you. Will you report back with a follow up?

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Yes 👍

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