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Onc pt: critical lows to critical highs in one wk


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Hello, new MLT here.  Does anyone have a physiological explanation for an oncology patient who went from critically low WBCs and PLTs to critically high WBCs and PLTs in one week.  Patient redrawn to rule out labeling error.  Experienced tech. said she had seen this critically low-to-critically high phenomenon once before in her career.

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A chemo patient will often have a suppressed bone marrow.  When the neutrophil count gets real low, they often will give the patient a drug like Neupogen to boost the count.  I do not think I have ever seen one go so high as to become critical, however.



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It's probably good to remember that everyone's critical highs and lows are different based on practice preferences. At the oncology practice where I work, the critical low WBC is 1.0 K/uL and the high is 100 K/uL. I can say that I've never seen this phenomenon, neupogen or not.

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