14 June 2013

Learning about Blood & Neutropenia: Questions

Blood is made up of red cells, white cells, plasma, and platelets. The functions of each are:
  • Red cells or erythrocytes  - Carries oxygen to and carbon dioxide from cells in the body.
  • White cells or leukocytes - Defend your body from germs, viruses, and bacteria
  • Plasma- Carries nutrients and suspends the other 3 components
  • Platelets or thrombocytes - Very important for clotting blood and repairing vessel walls
Blood also contains "clotting factors", which are also vital to the clotting process.

We know that Luke has some level of Neutropenia, which is a low neutrophil count.  Neutrophils are a component of a white blood cell.  Of the components of the WBC, the neutrophil is the best at "attacking" infections and we can see the work they do externally as they are responsible for creating scabs over open wounds. 

I've learned about a drug called "Neupogen" that can be administer daily to boost the production of neutrophils, however as Luke's ANC isn't severely low, it isn't something we've considered to this point and our hematologist has shared that she will want to complete a bone marrow biopsy prior to prescribing this medication.  That said, after speaking with a friend today whose son also has neutropenia, I have some questions (I have to give my friend Gretchen some credit here as she helped me brainstorm some of these ideas over lunch today...) 
  • Should we consider Neupogen as a pre-op methodology to help prepare Luke's body to fight off potential infections following his operation?
  • How will his recovery be implicated if he has a low ANC going into open heart surgery?
  • We know that he will be on the cardiopulmonary bypass (aka the heart-lung pump) and will receive a blood transfusion as part of the operation - how will blood products affect his ANC?
  • Will his CBC diff be ran regularly throughout the surgery to monitor his ANC and corresponding ability to fight infection?
  • Can we test for potential bacterial infections leading up to the surgery (like the week before?)
  • Should we do a 6 week blood study with Luke to validate he has cyclic neutropenia?  (i.e. two draws a week for six weeks?)
Additional Neutropenia Resources:

National Neutropenia Network

Understanding Severe Chronic Neutropenia: A Handbook for Patients and their Families

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