Killing Cancer · Editor's Cut · 10 min
Six patients with six different cancers, in their own words, and the one blood test none of them had heard of. Narrated, with Beth's chapter and Dr. Gary's introduction. Prepared for Secretary Kennedy and the Chief of Policy.
Absolute lymphocyte count · ALC
The lymphocytes are the T cells and natural killer cells that actually kill tumors. Their count is printed on every routine blood panel, and in most cancer clinics it is never treated. This site is about reading it.
Look for the row labeled Lymphocytes, absolute (or "Lymphs #", "ALC") on your complete blood count with differential. Below about 1,000 cells per microliter, the evidence says it matters.
What it is
Every complete blood count (CBC) with differential breaks your white blood cells into types. Neutrophils fight bacteria and are watched closely during chemotherapy, because when they crash you get an infection. Lymphocytes are different: they are the adaptive and innate immune cells, the T cells, B cells and natural killer (NK) cells, that recognize and destroy abnormal cells, including cancer.
The absolute lymphocyte count is the total number of those cells in a microliter of blood. Most labs report it as "Lymphocytes, absolute" or "Lymphs #" in cells/µL or thousands per µL (K/µL), next to a reference range that usually begins somewhere between 850 and 1,000 cells/µL. Below that is called lymphopenia. Ranges vary a little by lab, which is why the printed range on your own report is the one to use.
| Test | Result | Flag | Reference |
|---|---|---|---|
| WBC | 6.2 K/µL | 3.8–10.8 | |
| Neutrophils, absolute | 4.90 K/µL | 1.50–7.80 | |
| Lymphocytes, absolute | 0.53 K/µL | L | 0.85–3.90 |
| Monocytes, absolute | 0.55 K/µL | 0.20–0.95 | |
| Eosinophils, absolute | 0.18 K/µL | 0.015–0.50 | |
| Basophils, absolute | 0.04 K/µL | 0.00–0.20 | |
| Hemoglobin | 12.9 g/dL | 11.7–15.5 | |
| Platelets | 236 K/µL | 140–400 |
0.53 K/µL is 530 cells per microliter. Illustrative report; layouts and reference ranges differ by laboratory.
One patient's chart
Beth, 65, was diagnosed with Stage 3 colon cancer in April 2023, less than two years after a clean screening colonoscopy. Surgery removed twenty-four inches of colon and forty-four lymph nodes; six rounds of FOLFOX chemotherapy followed. By every measure her oncologists used, the treatment worked.
Her lymphocytes did not recover. For more than two years she pursued integrative and functional medicine while the count kept falling, to 525 in January 2026. In February 2026 she was enrolled in a clinical trial of an IL-15 immunotherapy at the Chan Soon-Shiong Institute for Medicine in California. After the first of ten injections, her count was 1,400.
"My total lymphocyte count dropped to 525. Normal starts around a thousand. My body could not recover from what the chemotherapy had done to it. I was cancer-free on paper and I was not well."
Honest label. The medicine Beth received, Anktiva (nogapendekin alfa inbakicept), is FDA-approved only for one form of bladder cancer. Its use to restore lymphocytes is investigational, in trials and expanded access. One chart is not a study. The studies are on the evidence page.
Why it matters
Across solid tumors and blood cancers, a lymphocyte count below roughly 1,000 cells/µL at diagnosis or during treatment is an independent predictor of chemotherapy toxicity, early death and shorter overall survival (Ménétrier-Caux et al., review).
Chemotherapy and radiation deplete lymphocytes far longer than they suppress neutrophils; in 297 patients on chemoradiation the median count fell 63% and stayed below 1,000 for a full year (Grossman et al., 2015). Neutropenia has approved drugs and monitoring rules. Lymphopenia has neither.
In 86 heavily pretreated metastatic pancreatic cancer patients, those whose lymphocytes were restored above 1,000 lived significantly longer than those who stayed lymphopenic (HR 0.46, p = 0.005) (QUILT-88, ASCO 2025). Company-reported, single-arm, and worth a randomized trial.
How the count comes back
Seventy seconds on what the rest of this site documents in footnotes: chemotherapy empties the blood of natural killer cells and T cells; Anktiva, an IL-15 signal, docks onto those cells and tells them to multiply; the restored army finds the tumor and destroys it. It is what took Beth's count from 525 to 1,400 after a single injection.
Prefer the news version? NewsNation's five-minute Killing Cancer segment shows the same mechanism with Dr. Soon-Shiong.
Start here
For patients & families
How to read the lymphocyte line on your CBC, what the grades mean, seven questions for your oncologist, and a wallet card to take to your next appointment.
Go to the patient guide →The prognostic literature, what current guidelines do and do not say about lymphocyte monitoring, the regulatory status of IL-15 therapy, and three specific requests to HHS.
Go to the policy brief →Six patients with six different cancers, in their own words, and one blood test none of them had heard of. Prepared for Secretary Kennedy and the Chief of Policy, with a narrated Present mode, the full interviews, Beth's chapter, and a signed family statement.
In their own words
Five patients treated with IL-15 immunotherapy, on the day they were diagnosed. Each clip opens at the moment quoted; the full interviews are in Killing Cancer.
"I had an annual physical. They found something in the urine."
"I was the last patient of the day, and he said, 'You have multiple myeloma.'"
"I was alone when I got my results. It was stage four. And I had like 24 tumors in my body."
"They did a CAT scan and said, 'Look, you have a major mass on the brain, and we need to remove it immediately.'"
"After six weeks of that surgery, my cancer was back."
What you can do
Print the wallet card. Hand it to your oncologist at the next visit.
Send Killing Cancer to someone in treatment, or to someone who sets policy.
Three specific requests to HHS, the brief, and the statement to Secretary Kennedy.
Get updates when new data, trials or guidance on lymphocyte monitoring appear.
