Can you have leukemia with normal blood count ?

I suppose: Theoretically, yes. Practically, no. Leukemia will not be suspected if the blood count is normal. In theory, leukemia, as it is first occurring, may affect the bone marrow before it affects the blood count. However, a bone marrow examination will probably not be done at that stage.

Sure: Cll (chronic lymphocytic leukemia) may have a normal count and the diagnosis is made on a lymph node biopsy.