Pediatric

Akiko Shimamura, MD

Institution
Dana-Farber/Boston Children’s Cancer and Blood Disorders Center
Physician Status
accepting new patients
Primary Disease Area of Focus
Aplastic Anemia
Myelodysplastic Syndromes (MDS)
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Pediatric
About
Dr. Akiko Shimamura directs the Bone Marrow Failure and Myelodysplastic Syndrome Program of the Dana Farber/Boston Children’s Cancer and Blood Disorders Center. Her research focuses on translational studies spanning clinical through basic science investigations to understand the genetic and molecular basis of bone marrow failure, MDS, and leukemia predisposition with the goal of developing more effective and less toxic treatments. Dr. Shimamura had previously directed the Bone Marrow Failure Clinic at Boston Children’s Hospital and then at Seattle Children’s Hospital before returning to Boston

Kasiani Myers, MD

Institution
Cincinnati Children’s Hospital Medical Center
Physician Status
accepting new patients
Primary Disease Area of Focus
Aplastic Anemia
Myelodysplastic Syndromes (MDS)
Paroxysmal Nocturnal Hemoglobinuria (PNH)
Pediatric
About
Dr. Kasiani Myers received her medical degree from Case Western Reserve University and pursued training in pediatrics and hematology/oncology at Cincinnati Children’s Hospital Medical Center. After completion of her postdoctoral training, she joined the faculty of the Division of Bone Marrow Transplantation and Immune Deficiency at Cincinnati Children’s Hospital Medical Center within the University of Cincinnati Department of Pediatrics. She is a recipient of the Procter Scholar Award to support her translational research in the field of bone marrow failure, including Fanconi anemia and

What is a complete blood count test (CBC)?

One important test your doctor will ask you to get is a complete blood count, or CBC for short. The CBC measures the number of each blood cell type in your blood sample. Below are the types of information the CBC measures.

  • Red blood cell count (RBC) measures the actual number of red blood cells in a given volume of blood. A low count is called .
  • White blood cell count (WBC) measures the actual number of white blood cells in a given volume of blood. A low count can mean you have an increased risk of getting an infection.
  • White blood cell differential (dif) looks at the types of white blood cells in your blood. There are many different types of white blood cells. Each of them protects you from different types of infections.
  • Hemoglobin (Hgb) measures the amount of this oxygen-carrying protein in red blood cells. This level is low in people with anemia.
  • Hematocrit (Hct) measures how much of a given volume of whole blood is made up of red blood cells. In healthy men, 41 percent to 50 percent of blood is red blood cells. In healthy women, 35 percent to 46 percent is red blood cells. This number is about 3 times the .
  • Platelet count measures the number of platelets in a given volume of blood. A low count means you have an increased risk of bleeding if you get cut or injured.
  • Mean Corpuscular Volume (MCV) measures the average size of red blood cells. It is high when red blood cells are larger than normal. It is low when red blood cells are smaller than normal.

 

Test

Adult Normal Range*
(Varies in different clinics or hospitals, or in different part of the U.S.)

count (varies with how high up you are in the mountains)

Men 4.7 to 6.1 million cells per microliter (cells/mcL)
Women 4.2 to 5.4 million cells/mcL

count

4,500 to 10,000 (4.5 to 10) thousand cells/mcL

Hemoglobin

Male 13.8 to 17.2 grams/dL
Female 12.0 to 15.6 grams/dL 

Male 40.7% - 50.3%
Female 36.1% - 44.3%

Platelets

150 to 450 thousand/mcL

MCV (Mean corpuscular volume)

80 to 100 femtoliter

*Normal blood values involve a range rather than a single volume.

Note:

  • cells/mcL = cells per microliter
  • gm/dL = grams per deciliter
  • pg/cell = picograms per cell

What are the symptoms of low blood counts?

The symptoms of diseases like , MDS and PNH are caused by low blood counts. The specific symptoms depend on which type of blood cell is affected. Read the section below to see the symptoms for each type of cell.

You may have many of these symptoms or just one or two of them. And you may get a new symptom at any point in the course of your illness.

Low Red Blood Cell Count

A low count is called . If you have a low red blood cell count, you may:

  • Feel a little tired or very tired.
  • Feel less alert or have trouble concentrating.
  • Have a loss of appetite or lose weight.
  • Have paler-than-normal skin.
  • Have trouble breathing.
  • Have rapid heartbeat.
  • Have reduced ability to exercise or climb stairs.

Low White Blood Cell Count

A low count is called neutropenia. If you have a low white blood cell count, you may:

  • Have repeated fevers and infections.
  • Get bladder infections that may make it painful to pass urine, or make you urinate more often.
  • Get lung infections that cause coughing and difficulty breathing.
  • Get mouth sores.
  • Get sinus infections and a stuffy nose.
  • Get skin infections.

Low Platelet Count

A low count is called thrombocytopenia. If you have a low platelet count, you may:

  • Bruise or bleed more easily – even from minor scrapes and bumps.
  • Get heavy menstrual periods.
  • Get nose bleeds.
  • Get tiny, flat red spots under your skin, which are caused by bleeding. These spots are called petechiae.
  • Have bleeding gums, especially after dental work or from brushing your teeth. Check with your doctor before getting any dental work.

What are low blood counts?

When you have a low blood count, this means your bone marrow is not making enough of one type of blood cells. Doctors call a low blood count . You can have one or more low blood counts.

Doctors use an important blood test called a complete blood count, or CBC for short, to measure the number of each blood cell in your blood sample. If the CBC shows a low number of red blood cells, white blood cells, or platelets, your doctor may look at the cells under a microscope. This is called a blood smear, and it can show if any blood cells are abnormal.

Low blood counts can have many causes, including vitamin deficiencies, bleeding, and rare bone marrow failure diseases like aplastic anemia, MDS and PNH. If your blood tests are abnormal, your doctor may do other blood tests or take a sample of your to find out why.

How are blood cells formed?

The process of making blood cells is called . Blood cells are made in the . That's a spongy tissue located inside some bones. It contains young parent cells called stem cells. These blood-forming stem cells can grow into all 3 types of blood cells – red cells, white cells and platelets. These blood-forming stem cells make copies of themselves, and they also produce mature blood cells. When blood cells are fully mature and functional, they leave the bone marrow and enter the blood. Healthy people have enough stem cells to keep making all the blood cells they need every day.

What are the different components of blood?

Blood is made of blood cells floating in . The plasma is mostly made of water with chemicals in it. These chemicals include proteins, hormones, minerals and vitamins.

There are three basic types of blood cells. These include:

  1. Red blood cells (RBCs) are also called erythrocytes. They make up almost half of blood. Red blood cells are filled with . That's a protein that picks up oxygen in the lungs and brings it to cells all around the body.
  2. White blood cells (WBCs) are also called leukocytes. They fight disease and infection by attacking and killing germs that get into the body. There are several kinds of white blood cells, each of which fights a different kind of germ.
  3. Platelets are also called thrombocytes. They are small pieces of cells that help blood clot and stop bleeding.
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