Leucocytosis
12 Mar, 2021
Dr. Rajesh Bollam
What is smokers leucocytosis ?
Does smoking increase WBC count ?
How to identify ??
Leucocytosis of unknown origin ...probes us to many investigations
Make it a point to check for history of smoking ?
What is Smoker’s Leukocytosis?
Smoking:
Induces cytokine release
Impairs the ability of alveolar macrophages to remove apoptotic material, propagating inflammation
Causes a systemic inflammatory response that leads to 
bone marrow release of leukocytes (Leukocytosis)
How to identify Smoker’s Leukocytosis?
-Mild, persistent elevation of WBC (<20.0)
-History of tobacco use
-Neutrophilia, lymphocytosis, and monocytosis on WBC differential
-Absence of myeloid precursors, blasts, or nucleated RBC
-H&P not suggestive of an alternate etiology
How I Treat Smoker’s Leukocytosis?
-Tell the patient that you think the WBC count is from
-Provide cessation counseling (appears to be effective in the setting of newly attributed Leukocytosis)
-Recheck CBC in 2 months (median time to improvement of WBC in the study)
In Summary:
-Asymptomatic Leukocytosis is challenging for clinicians
-Consider Smoker’s Leukocytosis in patients with tobacco use who have persistent, mild in WBC, without other concerning cells on WBC differential
-Provide cessation counseling
-Recheck CBC in 2 months
#DrRajeshBollam #Hematology #HematoOncologist #cancer #cancerdoctor #Hyderabad #Secundrabad
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