Nucleated Red Blood Cells And Leukemia: Links And Tests

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Medical News TodaySubscribeNucleated red blood cells and leukemia: What to know

Medically reviewed by Brett Barlow, MD — Written by Mathieu Rees on April 14, 2022

Overview of NRBCs
Link between NRBCs and leukemia
Symptoms
Other causes
Diagnostic tests
Treatments
Outlook
Other conditions
Questions for doctors
Summary

Nucleated red blood cells (NRBCs) are immature red blood cells that cannot perform their functions. They can indicate a person might have leukemia or another blood disorder, such as anemia.

Microscope used to analyse cells — Konstantin Voronov/Getty Images

Leukemias are cancers of the blood cells. This article will explore the link between NRBCs and leukemia. It also provides more information about leukemia and lists other conditions that a positive NRBC count might indicate.

Overview of NRBC and what it indicates

Red blood cells are an essential part of our bodies. These cells are responsible for carrying oxygen from our lungs to the body’s tissues. They can also carry carbon dioxide toward the lungs, through which it should leave the body.

Like all body parts, red blood cells must undergo stages of growth before reaching maturity.

As a recent article explains, NRBCs are immature red blood cells that, under typical conditions, are not present in a person’s blood circulation.

Research from 2022 associates the presence of circulating NRBCs with a poor prognosis in adults and newborns. However, there is insufficient research about the significance in children.

The link between nucleated blood cells and leukemia

Leukemia is a cancer of leukocytes, which are blood cells. People with this condition have leukocytes that grow in an atypical and uncontrolled manner.

In 2021, leukemia consisted of around 3.2% of all cancers in the United States, making it the tenth most common cancer in the U.S.

The American Cancer Society explains that there are four different kinds of leukemia:

acute myeloid leukemia
chronic myeloid leukemia
acute lymphocytic leukemia
chronic lymphocytic leukemia

These correspond with two important distinctions in leukemia types:

Myeloid vs. lymphocytic leukemia

Myeloid leukemia is when cancer affects myeloid cells, which include white blood cells, red blood cells, and platelets. Lymphocytic leukemia affects lymphocyte cells.

Acute vs. chronic leukemia

Leukemia is acute when it affects less mature and younger cells. In comparison, chronic leukemia affects mature, older blood cells.

Mutations, known as leukemic changes, cause the cells to grow and divide quickly. The resulting atypical cells can outnumber the healthy blood cells, which causes the blood to be less effective in its functions.

There is evidence that NRBCs have links to high mortality in many severe diseases, including leukemia.

Signs and symptoms

As a 2021 review explains, there are several different symptoms of leukemia. These include:

bruising
bleeding
fevers
lymphadenopathy, or enlargement of one or more lymph nodes
skeletal problems
enlarged liver or spleen
anemia

Anyone who experiences these symptoms should seek medical attention.

Other causes of leukemia

Scientists have not yet discovered the exact cause of leukemia, and its causes could vary according to the subtypes of the condition. However, scientists do know that some risk factors for leukemia exist. Factors that make the disease more likely include:

chemotherapy from a previous cancer
exposure to radiation
exposure to chemicals such as benzene
certain genetic syndromes, such as Down syndrome
certain viral infections, such as the Epstein-Barr virus

Research into the cause of leukemia is ongoing.

Diagnostic tests for leukemia

Making a diagnosis of leukemia can be complex. Doctors must often recommend a range of tests, such as:

a complete blood count
a complete metabolic panel
a liver function test
a bone marrow biopsy

As this article notes previously, a positive NRBC count could help doctors make more accurate and helpful leukemia diagnoses.

Treatments

Treatment depends on a person’s age, general health, and type of leukemia.

They may receive a combination of treatments that could include:

chemotherapy
biological therapy
radiation therapy
stem cell transplantation

Outlook

As leukemia can cause some challenging symptoms, living with the condition can be difficult. Since it can affect an individual’s well-being, people with leukemia may benefit from emotional support and mental health care.

When it comes to a prognosis, research shows that there is much variation from person to person. Factors that may affect a person’s outlook include:

their age
the difference in leukemia type
responsiveness to treatment
the presence of other health conditions

Scientists estimate that the 5-year cancer survival rate for leukemia has increased from 59% in 2005 to 65%, according to 2011–2017 data.

Other conditions indicated by NRBCs

Aside from leukemia, some other conditions might lead to positive NRBC blood counts.

For example, scientists define acute anemia as a sudden drop in red blood cell numbers.

Other conditions that prompt the body to produce more red blood cells, which may lead to NRBCs being present in the bloodstream, include the following:

hypoxia
hemorrhage
inflammation

Scientists also know that the spleen plays a role in storing damaged or defective red blood cells. Issues with the spleen could therefore also lead to NRBCs developing in a person’s bloodstream.

The presence of NRBC also has links to other serious conditions, including:

blood disorders
cardiovascular diseases
infections

Doctors will treat NRBCs according to the condition that is causing them, using specific lines of treatment.

Questions to ask doctors

If individuals have NRBCs within their bloodstream, it will be natural for them to ask their doctor for advice.

However, it may be difficult for healthcare professionals to answer them without further tests. People with a positive NRBC count may nonetheless wish to ask about the possible treatment strategies for the condition they might have.

Summary

Although NRBCs do not necessarily indicate leukemia, their presence in the bloodstream of adults does suggest another underlying disorder.

The treatment options for NRBCs vary depending on the cause.

Leukemia
Blood / Hematology
Cancer / Oncology

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Alder, L., et al. (2021). Acute anemia.https://www.ncbi.nlm.nih.gov/books/NBK537232/
Chennamadhavuni, A., et al. (2021). Leukemia.https://www.ncbi.nlm.nih.gov/books/NBK560490/
Kapila, V., et al. (2021). Physiology, spleen.https://www.ncbi.nlm.nih.gov/books/NBK537307/
Leukemia. (n.d.).https://www.hematology.org/education/patients/blood-cancers/leukemia
May, J. E., et al. (2019). Three neglected numbers in the CBC: The RDW, MPV, and NRBC count.https://www.ccjm.org/content/86/3/167
Pedersen, S. J. V., et al. (2022). Peripheral nucleated red blood cells and mortality in critically ill children.https://pubmed.ncbi.nlm.nih.gov/34486569/
Phan, T. T., et al. (2019). Emergence role of nucleated red blood cells in molecular response evaluation for chronic myeloid leukemia.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6731972/
What are the causes of leukemia? (n.d.).https://moffitt.org/cancers/leukemia/diagnosis/causes/
What is chronic myeloid leukemia? (2018).https://www.cancer.org/cancer/chronic-myeloid-leukemia/about/what-is-cml.html

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Medically reviewed by Brett Barlow, MD — Written by Mathieu Rees on April 14, 2022

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Overview of NRBC and what it indicates

The link between nucleated blood cells and leukemia

Myeloid vs. lymphocytic leukemia

Acute vs. chronic leukemia

Signs and symptoms

Other causes of leukemia

Diagnostic tests for leukemia

Treatments

Outlook

Other conditions indicated by NRBCs

Questions to ask doctors

Summary

How we reviewed this article:

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