Worried about CBC - can someone help me interpret please

[SUSIE225]

I just had a CBC done during a physical. I noticed that my lymphocyte count has been going up over the years and is a little bit over the reference range. I have no other symptoms and the doctor doesn't seem terribly worried, but my hypochondria is taking over. Should I be worried with these numbers? Thanks!

WBC Count 4.3 B/L
4.0 - 11.0 B/L
RBC Count 4.32 T/L
3.70 - 5.20 T/L
Hemoglobin 13.0 g/dL
12.5 - 15.0 g/dL
Hematocrit 38.6 %
36.0 - 46.0 %
MCV 89 fL
80 - 99 fL
MCH 30.1 pg
26.0 - 34.0 pg
MCHC 33.7 g/dL
32.0 - 37.5 g/dL
RBC Distribution Width 12.1 %
11.0 - 15.8 %
Platelet Count 230 B/L
140 - 400 B/L
MPV 9.3 fL
9.0 - 13.0 fL
Nucleated RBC 0.0 %
<=0.0 %
Neutrophils Relative 44.9 %
40.0 - 73.0 %
Lymphocytes Relative 44.7 %
20.0 - 44.0 %
Monocytes Relative 6.7 %
3.0 - 13.0 %
Eosinophils Relative 2.3 %
0.0 - 6.0 %
Basophils Relative 1.2 %
0.0 - 3.0 %
Immature Granulocytes Relative 0.2 %
0.0 - 0.7 %
Neutrophils Absolute (ANC) 1.93 B/L
1.60 - 8.00 B/L
Lymphocytes Absolute 1.92 B/L
0.80 - 4.80 B/L
Monocytes Absolute 0.29 B/L
0.10 - 1.40 B/L
Eosinophils Absolute 0.10 B/L
0.00 - 0.70 B/L
Basophils Absolute 0.05 B/L
0.00 - 0.30 B/L
Absolute Immature Granulocytes 0.01 B/L
0.00 - 0.06 B/L

[Ken_PA]

"...so I am assuming that is good.  "
Yes, it is.

What about a new medication then; or some chemical accidentally breathed, or swallowed in food or water? Any of that could relate to damage to the bone marrow, which is where blood cells are manufactured.

[Ken_PA]

No, there's no need to panic at all. You haven't mentioned that you get frequent infections, so that's very good. Your neutrophils are not technically low enough to be officially regarded as neutropenia anyway. If you have no symptoms, then there is not much to worry about for now. That's why I'd said it in a casual tone, "I'd want to eventually find out why the neutrophils are down-ish."

Also, I don't see it as a steadily downward trend. I instead see it more as an initial sharp drop, then holding more or less steady since then. Was there some event like an illness or accident that happened between when you were at 6.8 then dropped to 2.87?

[SUSIE225]

No accidents or illnesses that I can remember and honestly except for having Covid back in December, I haven't had a cold or anything like that in the past 2 years, so I am assuming that is good.  

[Ken_PA]

Hi, you want to look at the absolute numbers, not the relative. Your relative lymphocyte percent is up only because your neutrophils are down. It's mathematical.

Your Lymphocytes Absolute are actually less than the halfway point, and so is your overall WBC. A doc won't be worried because they are not really low, but if you have several past CBCs and you see a definite downward trend,  I'd bring that up to any doc you see for sure. But randomly going up and down over months is not really a worry.

"Should I be worried with these numbers?"
I'd want to eventually find out why the neutrophils are down-ish. They are normally the most numerous white blood cell.

There are many causes of "neutropenia" and a blood cancer is NOT at the top of the list of likely causes. I'd first think of some infection, but not if they have been steadily low for years. It's even possible that's normal for you as an individual. More clues are needed.

[SUSIE225]

My absolute neutrophils have been going down for the past 5 years - here is the trend:
6.80 2.87 2.99 2.38 1.93
Now I am panicked!