Usually: Leukemia is by definition a primary tumor of the blood-forming elements. If the cancer remains confined to the bone marrow, and the abnormal cells do not enter the blood ("aleukemic"), then the white count is often low because healthy cells are crowded out of the marrow. If the abnormal cells do spill over, the count is often high. The key is often that the cells look abnormal.
Answered 6/2/2015
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