Low wbc and platelets
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Low White Blood Cell (WBC) and Platelet Counts: Clinical Implications and Management
Introduction to Low WBC and Platelet Counts
Low white blood cell (WBC) and platelet counts can be indicative of various underlying health conditions and can significantly impact patient outcomes. Understanding the implications of these low counts and the methods for managing and monitoring them is crucial for effective clinical practice.
Methods for Accurate Counting of Low WBCs in Platelet Components
Accurate counting of low WBCs in platelet components is essential for quality control in transfusion medicine. A validated method using a large-volume hemocytometer has been shown to effectively count very low numbers of WBCs in platelet components, with an interobserver coefficient of variation of 11.9% for WBC concentrations greater than 2 per microL 1. This method, which employs crystal violet stain and a standard microscope, can be applied in routine quality control and clinical studies.
Prevention of Alloimmunization in Transfusion Therapy
In patients with acute leukemia, the use of WBC-reduced blood components has been shown to prevent alloimmunization and platelet refractoriness. A randomized trial demonstrated that patients receiving WBC-reduced platelet concentrates and red cells had a lower incidence of alloimmunization and transient HLA antibodies compared to those receiving standard blood components 2. This suggests that reducing WBCs in blood components can effectively prevent immune complications in transfusion therapy.
Quantitation of Very Low WBCs in Platelet Components
Flow cytometry with dual nucleic acid stains is another method for quantitating very low numbers of WBCs in platelet components. This method is linear over a wide range and provides sufficient reproducibility and sensitivity for routine analysis 3. It allows for the detection of nucleated cells labeled with specific stains, ensuring accurate WBC counts in platelet concentrates.
Impact of WBC and Platelet Counts on Acute Ischemic Stroke Outcomes
The combined effect of WBC and platelet counts on in-hospital mortality and pneumonia in acute ischemic stroke (AIS) patients has been studied extensively. High WBC count combined with low platelet count at admission is associated with a significantly increased risk of in-hospital mortality and pneumonia 56. This combination appears to be a better predictor of adverse outcomes than either WBC or platelet count alone.
Hematological Parameters in Pregnant Women at Different Altitudes
A study comparing hematological parameters in pregnant women at low and high altitudes found significant differences in WBC and platelet counts. Women at high altitude had lower WBC counts and higher platelet counts compared to those at low altitude 7. These differences were associated with variations in iron status markers, suggesting that altitude can influence hematological parameters during pregnancy.
Dietary Influence on WBC and Platelet Counts
Adherence to a Mediterranean diet has been associated with lower WBC and platelet counts, indicating reduced inflammation. A study involving healthy Italian citizens found that those with greater adherence to the Mediterranean diet had lower odds of being in the highest platelet-count group and higher odds of being in the lowest WBC-count group 8. This suggests that diet can play a role in modulating inflammation and related hematological parameters.
Conclusion
Low WBC and platelet counts have significant clinical implications, particularly in the context of transfusion therapy, acute ischemic stroke, and pregnancy. Accurate methods for counting low WBCs, such as large-volume hemocytometers and flow cytometry, are essential for quality control and clinical studies. Preventing alloimmunization through WBC-reduced blood components and understanding the combined effects of WBC and platelet counts on patient outcomes can improve clinical management. Additionally, factors such as altitude and diet can influence these hematological parameters, highlighting the importance of considering environmental and lifestyle factors in patient care.
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Most relevant research papers on this topic
Large‐volume hemocytometer chamber for accurate counting of white cells (WBCs) in WBC‐reduced platelets: validation and application for quality control of WBC‐reduced platelets prepared by apheresis and filtration
This large-volume hemocytometer method accurately counts very low numbers of white cells in platelet components, making it suitable for routine quality control and clinical studies.
Highly CitedPrevention of alloimmunization in patients with acute leukemia by use of white cell‐reduced blood components—a randomized trial
Reducing white cells in blood components effectively prevents alloimmunization in acute leukemia patients, potentially improving platelet survival.
RCTHighly CitedRoutine quantitation of white cells as low as 0.001 per microL in platelet components
This method effectively quantifies very low numbers of white cells in platelet components, with sufficient reproducibility and sensitivity for routine analysis of WBC-reduced platelet concentrates.
WBC content of platelet concentrates prepared by the buffy coat method using different processing procedures and storage solutions
Different processing methods and storage solutions can influence the WBC and platelet content of platelet concentrates prepared by the buffy coat method.
The prognostic significance of white blood cell and platelet count for in-hospital mortality and pneumonia in acute ischemic stroke.
High WBC count combined with low platelet count at admission is independently associated with in-hospital mortality and pneumonia in acute ischemic stroke patients, making the combination a better predictor than either count alone.
Observational StudyCombined Effect of White Blood Cell and Platelet Count for Predicting In-Hospital Mortality and Pneumonia in Acute Ischemic Stroke
High white blood cell count combined with low platelet count at admission is independently associated with in-hospital mortality and pneumonia in acute ischemic stroke patients, making their combination a better predictor than either count alone.
Observational StudyA Critical Analysis of the Automated Hematology Assessment in Pregnant Women at Low and at High Altitude: Association between Red Blood Cells, Platelet Parameters, and Iron Status
Pregnant women at high altitude have lower WBC, higher platelets, and higher serum ferritin, testosterone, and hepcidin, with varying effects on iron status and inflammation during gestation.
Observational StudyAdherence to the Mediterranean diet is associated with lower platelet and leukocyte counts: results from the Moli-sani study.
A Mediterranean diet is associated with lower platelet and white blood cell counts, potentially reducing inflammation and the risk of major chronic diseases.
Observational StudyHighly CitedResidual red cell and platelet content in WBC-reduced plasma measured by a novel flow cytometric method.
This study developed a novel flow cytometric method for detecting low levels of red blood cells, platelets, and platelet-MV in WBC-reduced plasma, making it suitable for routine quality monitoring and setting new specifications.
In Vitro Study