Recent advancements in gene therapy for sickle cell disease and β-thalassemia
Study Links Long COVID Severity With White Blood Cell Count
Higher levels of leukocytes -- a form of white blood cell -- are associated with more severe symptoms of long COVID among older women, researchers reported. Photo by Adobe Stock/HealthDay News
A simple blood test might determine which patients are at risk for long COVID, a new study says.
Higher levels of leukocytes -- a form of white blood cell -- are associated with more severe symptoms of long COVID among older women, researchers reported in a new study published Wednesday in the journal Menopause.
"Our findings suggest that leukocyte count, a well-standardized, stable, widely available, and inexpensive clinical marker of inflammation, is an independent predictor of future (long COVID) severity in postmenopausal women," the research team led by Ted Ng, an assistant professor with the Rush Institute for Healthy Aging at Rush University Medical Center in Chicago, concluded.
For the study, researchers analyzed blood samples taken from more than 1,200 women who participated in a COVID study between June 2021 and February 2022.
More than a third (36%) of the women suffered from long COVID symptoms, including memory problems (13%), "brain fog" (12%), or confusion or difficulty thinking or concentrating (11%), results show.
Of those women, 75% had two or more long COVID symptoms, researchers added.
Women with higher leukocyte counts tended to have more of these symptoms, and their symptoms tended to be more severe, researchers found.
"These findings are consistent with evidence showing that elevated inflammatory markers during or after COVID-19 infection are associated with subsequent (long COVID) severity and (long COVID)-associated symptoms," researchers wrote.
One theory of long COVID is that a person's initial infection causes heavy inflammation that does long-term damage to tissues and organs, resulting in lasting symptoms, researchers noted.
However, these results also might mean that the women were suffering from low-level inflammation prior to their COVID infection, researchers said. That existing inflammation could have made the disease even worse.
Further study is needed to better tease out the connections between long COVID and inflammation, and to verify the link between white blood cell counts and long COVID risk, researchers said.
Long COVID "significantly affects quality of life, often leading to severe disability," Dr. Monica Christmas, associate medical director for The Menopause Society, said in a news release.
"This effect is particularly pronounced in women, who already experience higher rates of cognitive impairment after menopause," added Christmas, who was not involved in the initial study. "By understanding underlying factors, we can better address these challenges and work to mitigate the cascade of symptoms that follow."
More information
The U.S. Centers for Disease Control and Prevention has more about long COVID.
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Are Lymphocytes High Or Low In Lymphoma? - Healthline
Doctors monitor lymphocyte and other blood cell levels to predict how your lymphoma will progress. Low lymphocyte counts may suggest that cancer has spread to your bone marrow, or it can be a side effect of treatments.
Lymphoma is a group of cancers that develop in your lymphocytes. These white blood cells are found inside your lymph nodes and other parts of your lymph system. Cancerous lymphocytes replicate uncontrollably and can crowd out healthy blood cells.
Doctors don't use the results of blood tests to diagnose lymphoma, but they can use them to:
Read on to learn more about the role that lymphocyte monitoring plays in diagnosing and treating lymphoma.
What is a lymphocyte?A lymphocyte is a group of white blood cells. Your white blood cells play an important role in identifying and attacking foreign invaders and cancer cells. Each white blood cell has a specific function depending on its type.
The main types of lymphocytes are:
Blood tests aren't used to diagnose lymphoma, but they're important for monitoring your disease. You'll likely receive blood tests throughout your diagnosis and during your treatment to assess your:
People with lymphoma have high levels of abnormal lymphocytes that replicate quickly. These abnormal cells don't function properly and can crowd out healthy lymphocytes and other blood cells.
Lower blood cell counts are responsible for many of the characteristic symptoms of lymphoma such as easy bruising and fatigue.
A higher-than-normal level of lymphocytes in your blood suggests you may have blood cancer, but it can also be a sign of some other conditions such as an active infection.
The normal range of lymphocytes can vary between laboratories since laboratories may have different ways to measure your sample. Here's a general idea of what's considered a higher or lower lymphocyte count than average.
Young children typically have higher lymphocyte counts than adults. A doctor may consider your child's lymphocyte count low if it's fewer than 2,000/μL.
When examining your blood cell counts, doctors also often look at the breakdown of your total white blood cell count. This test is called a white cell differential test, and it's often ordered as part of a complete blood count.
Lymphocytes and other blood cells are produced in stem cells in your bone marrow. A low lymphocyte count is generally associated with a less favorable outlook since lymphocytes help your body monitor and destroy cancer cells.
In a 2019 study, low lymphocyte count trended toward worse survival in people with aggressive non-Hodgkin's lymphoma but didn't reach statistical significance (meaning the association between low lymphocyte counts and poorer survival rates could be attributed to chance or other random factors).
Researchers in this study reported the following survival rates:
Low blood cell counts can suggest that the cancer has spread to your bone marrow. Special stem cells in your bone marrow produce new blood cells.
Low blood cell counts can also be a side effect of some lymphoma treatments such as chemotherapy. Usually, your blood cell levels return to normal once treatment is finished.
What other conditions might cause low lymphocyte levels?Many conditions other than lymphoma can lead to low lymphocyte levels. Some of these conditions include:
What To Know About Treatment For Sickle Cell Anemia
Sickle cell anemia is the most severe form of sickle cell disease (SCD). Treatments for sickle cell anemia include medications, blood transfusions, and bone marrow transplants.
SCD is a group of genetic disorders that causes misshapen red blood cells (RBCs), which are curved and resemble sickles. These RBCs do not travel easily through blood vessels and can cause blockages in blood flow, potentially leading to severe complications.
People with sickle cell anemia should consult a doctor to find out which treatment options may be best for them.
This article discusses a variety of treatments for sickle cell anemia.
Voxelotor (Oxbryta) is a medication that prevents RBCs from developing a sickle shape and binding to each other. This may stop the body from destroying some RBCs and, as a result, may reduce the risk of anemia and improve blood flow to the organs.
Side effects and risks
Possible side effects include:
This medication helps reduce the risk of blood cells clinging to blood vessel walls. As a result, crizanlizumab-tmca (Adakveo) may reduce a person's risk of pain crises, blood vessel blockages, and inflammation.
Side effects and risks
Possible side effects include:
In adults, this medication may help reduce pain crises and lower the risk of acute chest syndrome, which is a medical emergency. It may also improve the number of RBCs and reduce the number of times a person needs blood transmissions and hospital admissions.
In children, hydroxyurea may reduce the number of blood vessel blockages and hospital admissions. It may also help prevent pain episodes and swelling in the hands and feet.
Side effects and risks
Hydroxyurea may reduce the number of white blood cells or platelets in the blood. In rare cases, it can make anemia worse. However, stopping the use of hydroxyurea can reverse these side effects. Doctors may then prescribe it again at a lower dose.
Pregnant people should not take hydroxyurea, and its effects on children under 9 months of age are not known.
Side effects and risks
According to the United Kingdom's National Health Service (NHS), ibuprofen may cause the following negative effects:
People should always speak with a healthcare professional for guidance before taking any pain relief medications.
Children with sickle cell anemia may need two daily doses of penicillin to reduce their risk of a severe infection traveling through the blood. Newborns take penicillin as a liquid, and older children can take penicillin in pill form.
Some doctors stop prescribing this medication after 5 years of age. Others may recommend penicillin as a lifelong medication, especially for people who have had surgery to remove their spleen or have had an infection called pneumococcus.
Doctors may also recommend that people with hemoglobin SS and sickle cell beta-thalassemia take penicillin for the rest of their lives.
Side effects and risks
Different types of penicillin have varying side effects. These might include:
Blood transfusions can help replace sickle-shaped RBCs with typical ones that travel more efficiently around the body. They can also help treat complications that may lead to severe anemia, stroke, acute chest crises, and multiple organ failure.
Before a person with sickle cell anemia undergoes any type of surgery, a doctor may request that they receive a transfusion to reduce the risk of complications.
Transfusions may decrease the likelihood of another stroke in people who have already had a stroke due to sickle cell-related blockages. They may also decrease the chances of a first stroke in children who have abnormal transcranial Doppler ultrasound results that suggest an increased risk of stroke.
Additionally, transfusions can be an alternative to hydroxyurea for those who do not tolerate its side effects well.
Side effects and risks
A process called alloimmunization can cause the body to "reject" the blood transfusion, making it difficult to find a match for the next blood donation.
Currently, the only way to cure sickle cell anemia is by replacing a person's bone marrow with bone marrow from a donor who is a close genetic match. However, not everyone has a well-matched donor.
Most transplants for sickle cell anemia occur in children who have experienced pain crises, recurring chest crises, and strokes. The procedure is riskier for adults.
Bone marrow transplants are successful in around 85% of children who receive bone marrow from a well-matched, related donor.
Side effects and risks
Bone marrow transplants can lead to serious complications, including:
The mortality rate due to complications after bone marrow transplant procedures is around 5%. Some medications can reduce the risk of complications.
In 2023, the FDA approved two cell-based gene therapies, Casgevy and Lyfgenia, to treat SCD in people ages 12 years and older.
Both therapies involve modifying a person's own blood stem cells and then returning them to the person's body through an infusion as part of a stem cell transplant. These cells then help the person produce functioning RBCs.
Side effects and risks
The most common side effects of Casgevy include:
Possible side effects of Lyfgenia include:
People should also note that Lyfgenia comes with a boxed warning regarding the risk of blood cancer, so doctors will monitor anyone who receives this therapy for blood cancer.
Below are some common questions and answers about sickle cell anemia.
What is the most common treatment for sickle cell anemia?
A person may also receive blood transfusions and other treatments as needed.
What worsens sickle cell anemia?
According to the NHS, potential triggers for sickle cell crises include:
Is sickle cell disease a lifelong condition?
SCD is a lifelong condition, although it is curable through bone marrow transplants. However, these procedures are risky, especially in adults.
People may manage SCD with medications and blood transfusions.
Sickle cell anemia treatments include medications to manage pain and prevent complications such as infection and stroke. Blood transfusions can provide more functional RBCs that can help treat and manage crises and prevent further complications.
A bone marrow transplant can cure SCD. However, this procedure has a high risk of complications, and donors often need to have a close genetic link to the recipient.
People with SCD should talk with their doctor to find out which treatments may work best for them.
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