ipi blood work questions?

Regarding the eosinophils and reading bloodwork in general: 

When white blood cell counts are reported they give you 2 numbers- the percentage and the absolute count. In your case you report a percentage change from 2.7 to 8 with an absolute count change from 0.2 to 0.5. The absolute count is exactly that (well, technically it's a concentration, but hey lets keep with simplicity)- how many of that particular white blood cell per unit volume of whole blood. Typically there is also a normal range next to the numbers. I'm guessing that for the absolute count your increase is still within the normal range (probably at the high end or possibly just over) which means the change is not significant. 

With regard to the change in percentage, often those look scarrier than they are. They are exactly that- a percentage of the white blood cells on that day. All of the white blood cells together equal 100%, then they are broken down into percentages for each cell type. Often you see bigger (and scarier looking) changes in the percentage than in the absolute counts, but it's the counts that really matter. The percentages will also have normal ranges and my guess is that 8 is above the upper limit reported on your normal range. The most numerous (and therfore proportionally largest) white blood cell we have are neutrophils (generally reported at the top of the list). The numbers of these cells can fluctuate quite a bit within their normal range, changing the relative percentages of the other cells. The increase in percentage of eosinophils is likely reflecting a slight decrease in neutrophils, thereby increasing the relative proportion of eosinophils. E.g. if you have 10 beans- 5 red, 2 blue and 3 green then you take away 2 of the red ones and calculate a new percentage it's going to look like the number of blue beans has increased, when really it hasn't.

Both the percentages and numbers give information to doctors, but the simple answer for most people is ignore the percentages (and their changes) and pay attention to the absolute counts. Also keep in mind that numbers only slightly higher or lower than the "normal range" are nothing to worry about (this goes for chemistry panels with liver and kidney values, etc on them as well). 

Regarding the lymphocytes, I'm honestly not sure- it's been a while since I've done much reading about the effects of Ipi on blood counts and whether or not they mean anything (presence or absence of other side effects with Ipi don't mean a darn thing). I can tell you though that I did carry an increased number of eosinophils throughout my Ipi therapy last summer, although they were high prior to starting Ipi from the IL-2 I had before. With IL-2  high eosinophils are considered a good thing, so it may also be true of other immunotherapies. My lymphocytes did not significantly change one way or the other. I had the same thoughts as you that they should be increasing- it would be interesting to hear what other's experience was. 

I hope this wasn't too confusing

-Eva

Regarding the eosinophils and reading bloodwork in general: 

When white blood cell counts are reported they give you 2 numbers- the percentage and the absolute count. In your case you report a percentage change from 2.7 to 8 with an absolute count change from 0.2 to 0.5. The absolute count is exactly that (well, technically it's a concentration, but hey lets keep with simplicity)- how many of that particular white blood cell per unit volume of whole blood. Typically there is also a normal range next to the numbers. I'm guessing that for the absolute count your increase is still within the normal range (probably at the high end or possibly just over) which means the change is not significant. 

With regard to the change in percentage, often those look scarrier than they are. They are exactly that- a percentage of the white blood cells on that day. All of the white blood cells together equal 100%, then they are broken down into percentages for each cell type. Often you see bigger (and scarier looking) changes in the percentage than in the absolute counts, but it's the counts that really matter. The percentages will also have normal ranges and my guess is that 8 is above the upper limit reported on your normal range. The most numerous (and therfore proportionally largest) white blood cell we have are neutrophils (generally reported at the top of the list). The numbers of these cells can fluctuate quite a bit within their normal range, changing the relative percentages of the other cells. The increase in percentage of eosinophils is likely reflecting a slight decrease in neutrophils, thereby increasing the relative proportion of eosinophils. E.g. if you have 10 beans- 5 red, 2 blue and 3 green then you take away 2 of the red ones and calculate a new percentage it's going to look like the number of blue beans has increased, when really it hasn't.

Both the percentages and numbers give information to doctors, but the simple answer for most people is ignore the percentages (and their changes) and pay attention to the absolute counts. Also keep in mind that numbers only slightly higher or lower than the "normal range" are nothing to worry about (this goes for chemistry panels with liver and kidney values, etc on them as well). 

Regarding the lymphocytes, I'm honestly not sure- it's been a while since I've done much reading about the effects of Ipi on blood counts and whether or not they mean anything (presence or absence of other side effects with Ipi don't mean a darn thing). I can tell you though that I did carry an increased number of eosinophils throughout my Ipi therapy last summer, although they were high prior to starting Ipi from the IL-2 I had before. With IL-2  high eosinophils are considered a good thing, so it may also be true of other immunotherapies. My lymphocytes did not significantly change one way or the other. I had the same thoughts as you that they should be increasing- it would be interesting to hear what other's experience was. 

I hope this wasn't too confusing

-Eva

Regarding the eosinophils and reading bloodwork in general: 

When white blood cell counts are reported they give you 2 numbers- the percentage and the absolute count. In your case you report a percentage change from 2.7 to 8 with an absolute count change from 0.2 to 0.5. The absolute count is exactly that (well, technically it's a concentration, but hey lets keep with simplicity)- how many of that particular white blood cell per unit volume of whole blood. Typically there is also a normal range next to the numbers. I'm guessing that for the absolute count your increase is still within the normal range (probably at the high end or possibly just over) which means the change is not significant. 

With regard to the change in percentage, often those look scarrier than they are. They are exactly that- a percentage of the white blood cells on that day. All of the white blood cells together equal 100%, then they are broken down into percentages for each cell type. Often you see bigger (and scarier looking) changes in the percentage than in the absolute counts, but it's the counts that really matter. The percentages will also have normal ranges and my guess is that 8 is above the upper limit reported on your normal range. The most numerous (and therfore proportionally largest) white blood cell we have are neutrophils (generally reported at the top of the list). The numbers of these cells can fluctuate quite a bit within their normal range, changing the relative percentages of the other cells. The increase in percentage of eosinophils is likely reflecting a slight decrease in neutrophils, thereby increasing the relative proportion of eosinophils. E.g. if you have 10 beans- 5 red, 2 blue and 3 green then you take away 2 of the red ones and calculate a new percentage it's going to look like the number of blue beans has increased, when really it hasn't.

Both the percentages and numbers give information to doctors, but the simple answer for most people is ignore the percentages (and their changes) and pay attention to the absolute counts. Also keep in mind that numbers only slightly higher or lower than the "normal range" are nothing to worry about (this goes for chemistry panels with liver and kidney values, etc on them as well). 

Regarding the lymphocytes, I'm honestly not sure- it's been a while since I've done much reading about the effects of Ipi on blood counts and whether or not they mean anything (presence or absence of other side effects with Ipi don't mean a darn thing). I can tell you though that I did carry an increased number of eosinophils throughout my Ipi therapy last summer, although they were high prior to starting Ipi from the IL-2 I had before. With IL-2  high eosinophils are considered a good thing, so it may also be true of other immunotherapies. My lymphocytes did not significantly change one way or the other. I had the same thoughts as you that they should be increasing- it would be interesting to hear what other's experience was. 

I hope this wasn't too confusing

-Eva