neutropenia, leukopenia and thrombocytopenia

[ang123]

Do any of your kids just" have" this. O's anc runs in 500-900 range but as low as 300 and hasn't been even low normal for a few months now. Her wbc is 3-4 and never above 6. Both only drop with infection....never increase even into normal range. Any thoughts? Concerned that this is causing her frequent line infections. She is always anemic (hgb 8-10) and her platelets fluctuate between 100-150 so not terrible but often below normal.

[Cathy]

I've only dealt with neutropenia, so I can't speak to the rest, but my son has/had autoimmune neutropenia. For a solid year we didn't get anything above 1000 for his ANC (once it was down to 50), and it dropped with every illness and vaccines. So in a sense he "just has it" - he developed antibodies to his own neutrophils so any stress on his immune system would kill off his neutrophils quickly.

I'm not sure if the other blood disorders can exist in the same way, but his cbcs always came back kind of funky until the anc stabalized in the past 6 months or so.

Genetics ran some extra tests on him because of it, and I know they said a bone marrow aspiration was a possibility if the antibody test had come back negative. It's probably worth a trip through hematology to find out and see what the options are.

[ang123]

Thanks Cathy, we have done a bone marrow biopsy and hem has been following her for over a year for the anemia. The neutropenie/low wbc (maybe its the same?) has become more of a problem over the past three months (since her bone marrow biopsy). The bmb then showed trileneage decrease or somethimg but was curious what effects having the low neutrophils and wbc had had, if any, on peoples kids and what they have done about it???

[Susan]

Karuna had it is as a baby, but it resolved for the most part. Now she only gets issues when sick, and those have changed with her autoimmune disease.

[jhilliard]

E has had months were pancytopenia happens off and on- but usually only the RBC count stays consistently low when she's not acutely infected. She had a bone marrow biopsy last summer that showed hypoplastic marrow in all 3 cell lines- it wasn't quite bad enough to qualify as full bone marrow "failure" but was pretty bad. She has had pancreatic insufficiency for most of her life as well, and as the two frequently go together she was examined for SDS, and Pearsons (a mitochondrial bone marrow failure disease)- but all was negative. So, we just call it a "Pearsons-like" mitochondrial issue, and chalk it up to the overall mito monster.

As for treatment, only the RBC counts have been bad enough to consistently need addressing, and we transfuse her with packed RBCs frequently.