Absolute Monocytes Explained in Simple Terms

What is a High Monocyte Count?

A high monocyte count means that there are too many white blood cells (WBC) in your body. A normal number of WBC is around 100,000 per milliliter of blood. A higher number indicates a greater risk for infection and disease. If you have a high number of WBC then your immune system will attack them first because they look like foreign invaders. When your body attacks these invaders, it damages tissue and organs.

The higher the number of WBC, the greater the chance of getting an infection or contracting a disease such as cancer. Your doctor may recommend treatment with drugs to lower your WBC count. Some doctors even suggest treating high numbers of WBC with radiation therapy.

There is no evidence that either approach works and could cause harm to your health.

How Do You Know if Your Number Is Too High?

If you have a high number of WBC, then your doctor will probably order tests to determine whether or not you need treatment. These tests include:

Blood Tests – Blood counts are done to measure the amount of red blood cells and platelets in your bloodstream. They show how well your body is protecting itself from infections and diseases. A high number of red blood cells means that your body isn’t making enough antibodies against germs and viruses.

A low number means that you bleed too easily and are more likely to get an infection.

A low platelet count makes it difficult for your blood to clot. The condition is called thrombocytopenia. If you have a high number of WBC, you can develop a condition called Thrombocytosis in which too many platelets form clots and block small arteries and veins.

This can lead to a heart attack or a stroke.

Blood Smear Test – A blood smear is a test used to examine a sample of your blood under a microscope. The technician can count the number and type of WBCs. For an accurate count, the technician needs to have a good sample of your blood.

You may need to fast (don’t eat) for eight hours before the test or the technician may ask you to come back at another time.

Complete Blood Count (CBC) – A complete blood count (CBC) is a more in-depth test that measures all of the elements of your blood including hemoglobin, hematocrit, platelets, white blood cells, red blood cells, and other elements. The test can help your doctor detect anemia, blood clotting problems, leukemia, and other disorders.

How Is It Treated?

Most healthcare providers don’t treat high WBC unless the patient also has an underlying disorder or a condition such as HIV or cancer. If your count is high, your doctor will focus on treating the underlying disorder rather than the WBCs. You may be placed on a medication such as prednisone to lower the WBC level. This is often a temporary measure and the drug can have a number of unpleasant side effects.

The doctor may order a bone marrow biopsy to obtain a sample of bone marrow for testing. This involves using a long, needle-like instrument to withdraw a sample of bone marrow from your hipbone. The procedure may be uncomfortable but it is relatively safe and causes minimal discomfort due to the anesthetic used.

Another way to lower your WBC is through radiation therapy. A doctor who specializes in radiation therapy provides an estimate of how many treatments you need based on your weight, overall health, and the type and location of your tumor. Treatment typically lasts five days a week for between one and three weeks.

During this time, you will be given a shield to wear over the area being treated. For the remainder of each day you will be exposed to a low level of radiation.

The most common side effects of radiation therapy include:



Loss of Appetite

Hair Loss

Skin Damage (sunburn-like)

Allergic Reactions to Medicine or Vaccines: Occasionally, your healthcare provider may recommend that you receive a vaccine (such as the seasonal influenza vaccine) or take a medicine such as antibiotics to prevent or treat an infection. If you have an allergic reaction to a vaccine or medicine, it can affect the number of WBCs in your bloodstream.

Treating Leukemia

There are a variety of different types of leukemia. The type and severity determine the course of treatment. A few of the most common forms of treatment are described here.

Before beginning treatment, your healthcare team will perform a bone marrow biopsy to confirm the type and severity of the leukemia.

Chemotherapy – Chemotherapy involves taking anti-cancer drugs that travel through the bloodstream to every tissue of the body. There, the drugs kill cancer cells instead of normal, healthy cells.

Chemotherapy often causes side effects such as nausea, fatigue, loss of appetite, hair loss, and more. These will vary depending on the drugs used and can be treated with different medications.

Different types of chemotherapy drugs are more effective against certain cancers than others. Chemotherapy is often given in combination with other cancer treatments such as radiation therapy or biological therapy.

Biological Therapy – Biological therapies are also known as biotherapy or immunotherapies. These drugs treat diseases by stimulating your body’s natural defenses to fight the disease itself. These drugs may come in the form of antibodies, growth factors, vaccines, and cells that are similar to your own.

Biological therapies can often be given in an outpatient setting, such as a physician’s office. Common side effects of these drugs include nausea, diarrhea, fatigue, and fever. Your doctor may recommend that you take the drug an hour after eating, to reduce nausea.

Stem Cell Transplants – A stem cell transplant involves replacing cancerous bone marrow with healthy bone marrow from a donor.

Sources & references used in this article:

Peripheral blood absolute lymphocyte/monocyte ratio as a useful prognostic factor in diffuse large B‐cell lymphoma in the rituximab era by R Watanabe, N Tomita, M Itabashi… – European Journal of …, 2014 – Wiley Online Library

The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large-B-cell lymphoma by RA Wilcox, K Ristow, TM Habermann, DJ Inwards… – Leukemia, 2011 – nature.com

The prognostic impact of absolute lymphocyte and monocyte counts at diagnosis of diffuse large B-cell lymphoma in the rituximab era by K Aoki, S Tabata, N Yonetani, A Matsushita… – Acta …, 2013 – karger.com

Quantitative and qualitative profiles of circulating monocytes may help identifying tuberculosis infection and disease stages by MP La Manna, V Orlando, F Dieli, P Di Carlo, A Cascio… – PloS one, 2017 – journals.plos.org

Prognostic value of lymphocyte-to-monocyte ratio in patients with solid tumors: a systematic review and meta-analysis by TF Nishijima, HB Muss, SS Shachar, K Tamura… – Cancer treatment …, 2015 – Elsevier

Cigarette smoking and peripheral blood leukocyte differentials by J Schwartz, ST Weiss – Annals of epidemiology, 1994 – Elsevier