Can ANTIBIOTICS cause low LYMPHOCYTE COUNT?

Resolved question:
I just had a blood count taken (finished chemo for breast cancer in august).

WBC=2.7
RBC=4.28
Platelets=212
Lymphocytes=.65
CAN ANTIBIOTICS CAUSE A LOW LYMPHOCYTE COUNT????


I have been on doxycycline (but stopped a week ago) for a cellulitis that had been caused by radiation. Also, I was on Bactrim before that. i AM VERY WORRIED THAT THE LOW LYMPHOCYTE COUNT WILL KEEP MY BODY FROM FIGHTING THE CANCER. IS THIS TRUE? HOW LIKELY IS A BAD OUTCOME??

Submitted: 4 Days
Category: Oncologist

Expert:  Dr. Prasad Eswaran replied 4 Days.

Hello,
Thank you for your query.
Doxycycline could cause decrease in blood counts due to bone marrow suppression. Please send your previous blood reports. Do you have any fever or any symptoms of infection ?
Please send a peripheral smear study report if available .
This decrease in blood counts do not hamper the im munity that it affects the resistance against cancer.
Kindly revert with all the reports.
Regards

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Patient replied :

Thank you. I do not have the peripheral smear study. I can tell you that 2 months after chemo, my lymphocytes were 1.0 (in October). WBC was 2.5 and Neutrophils were 1.2. Had not had radiation yet. Had radiation in November--no blood studies until Feburary though. Next blood report was February and WBC was 4.0, Neutrophils were 2.9 and Lymphocytes had dropped to .6. I was on Bactrim and Augmentin for cellulitis then. Next blood report was at the end of March: WBC 3.6, Neutrophils 2.3 and Lymphocytes were .9. I had just finished the Bactrim and had started a very mild cellulitis again. They were just about to switch me to Doxycycline. I had also exercised a lot that day--I've heard it increases blood counts. Because note that the Lymphocytes were up a bit. April 6: WBC 2.2, Neutrophils 1.3 and Lymphocytes .7. (on doxycycline) April 12: WBC 2.2, Neutrophils 1.5 and Lymphocytes .57. (on doxycycline) April 19: WBC 2.7, Neutrophils 1.8 and Lymphocytes .65. (finished doxycycline a few days before). In all cases the red count and hemoglogin and platelets are normal. My doctor did not order all those blood counts--I went and got them because I was scared. He is not that worried about the blood counts for some reason. So you are reallly sure that doxycycline could lower LYMPHOCYTES???--not only neutrophils? Also, It makes me feel better when you say that decrease in blood counts does not hamper immunity against cancer. But, here is my question: I thought the "killer" cells that kill random cancer cells in your body were lymphocytes--they are the T-cells. If I have a low lymphocyte count, wouldn't that make me more likely to get cancer? Either a new cancer entirely, or a recurrence? I hope you can make me feel better about this. Because I am really scared. I have heard that radiation can keep your lymphocytes permanently low--although I guess mine went up to .9 in March. Thank you again.


Expert:  Dr. Prasad Eswaran replied 3 Days.

Dear,
Radiation was given to chest wall region only. Effect on chemo has suppressive effect on bone marrow for sometime. I would suggest you to improve your nutritional status.
Regrding, cancer immunity it is more specific cytotoxic T cells and macrophages acting on cancer cells. Not the B cells. So this temporary decline will not hamper cancer immunity
Regards

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Patient replied :

But the Tcells ARE lymphocytes. If this decline is not temporary it WOULD affect cancer immunity, right? Also, how would doxycycline lower the lymphocytes?


Expert:  Dr. Prasad Eswaran replied 2 Days.

Cytotoxic cells are generally resistant for chemotherapy action. But not always. They have higher chances of continued activity even after exposure to chemo.
Doxycycline can exert its side effect on proliferating bone marrow cells.
Regards

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Patient replied :

Thank you. But are the cytotoxic cells resistant to radiation?? Because my counts were coming back, but dropped after the radiatioin. If I have a low lymphocyte count, aren't some cytotoxic cells missing?
In other words, can I fight new cancer cells with a .65 lymphocyte count? I think my macrophages are low too, because my monocytes are at .2. They are at the very low end. Do I have a good chance of fighting off new cancers with this going on?
Also, do other antibiotics than doxycycline cause bone marrow suppression? Does bactrim? Does Augmentin?


Expert:  Dr. Prasad Eswaran replied 1 Day.

May be , Yes. But quantification is difficult. Usually the decline is temporary and recovers with time.
Augmentin does not cause immunosuppression.
Bactrim may cause similar side effects, but chances are low.

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