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A positive nucleated red blood cell (NRBC) count may indicate that the individual has leukemia. However, positive NRBC counts could also indicate different conditions. Share on PinterestKonstantin Voronov/Getty ImagesNRBCs are immature red blood cells that cannot perform their functions. These types of red blood cells may indicate conditions such as leukemia. However, not every person with NRBCs in their bloodstream has leukemia. Instead, it may suggest other blood disorders such as anemia. 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 leukemiachronic myeloid leukemiaacute lymphocytic leukemiachronic 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:bruisingbleedingfeverslymphadenopathy, or enlargement of one or more lymph nodesskeletal problemsenlarged liver or spleenanemia 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 cancerexposure to radiationexposure to chemicals such as benzenecertain genetic syndromes, such as Down syndromecertain 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 counta complete metabolic panela liver function testa 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:chemotherapybiological therapyradiation therapystem 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 agethe difference in leukemia typeresponsiveness to treatmentthe 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:hypoxiahemorrhageinflammation 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 disorderscardiovascular diseasesinfections 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. Last medically reviewed on April 13, 2022LeukemiaBlood / HematologyCancer / Oncology 9 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. 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/leukemiaMay, J. E., et al. (2019). Three neglected numbers in the CBC: The RDW, MPV, and NRBC count.https://www.ccjm.org/content/86/3/167Pedersen, 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.htmlFEEDBACK:Medically reviewed by Brett Barlow, MD — By Mathieu Rees on April 13, 2022 Latest newsWhat sets 'SuperAgers' apart? 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