Health Test Categories & Biomarkers

Blasts are immature blood cells, typically found in the bone marrow, where they develop into mature blood cells (such as red blood cells, white blood cells, and platelets).

Types of blasts include myeloblasts, lymphoblasts, erythroblasts, and megakaryoblasts, which eventually mature into neutrophils, lymphocytes, red blood cells, and platelets, respectively.

In a healthy individual, very few, if any, blasts are present in the bloodstream, as they normally mature in the bone marrow before being released. However, blasts in the blood can be a sign of a serious condition, such as leukemia or other bone marrow disorders.

Abnormal Blast Levels

High Blast Levels - Causes

Leukemia: One of the most common causes of elevated blast levels is leukemia, a type of blood cancer. In leukemia, blasts fail to mature properly and proliferate uncontrollably.
Acute myeloid leukemia (AML): Characterized by an accumulation of myeloblasts.
Acute lymphoblastic leukemia: Marked by an excess of lymphoblasts.
Myelodysplastic syndromes (MDS): These disorders are caused by poorly functioning bone marrow, leading to abnormal production of immature blood cells, including blasts.
Chronic myeloproliferative disorders: Certain conditions, like chronic myelogenous leukemia (CML), can lead to an increased number of blasts in the later stages of the disease.
Bone marrow failure: Aplastic anemia or other conditions that cause bone marrow failure may lead to an abnormal increase in immature cells (blasts) as the bone marrow tries to compensate.
Infections or inflammation: In rare cases, severe infections or inflammatory conditions can cause elevated blast counts as the body ramps up the production of immune cells.
Chemotherapy or radiation: Certain cancer treatments can damage the bone marrow and cause the release of blasts into the bloodstream.

High Blast Levels - Symptoms

The symptoms associated with abnormal blast levels are usually linked to the underlying condition, such as leukemia or bone marrow disorders. Common symptoms include:

Fatigue and weakness: A lack of mature red blood cells (anemia) can cause persistent tiredness.
Frequent infections: Due to a deficiency of mature white blood cells, the immune system is compromised.
Easy bruising or bleeding: Low platelet levels lead to increased bruising, nosebleeds, or bleeding gums.
Bone pain: Bone marrow expansion due to the excessive production of blasts can lead to pain, particularly in the long bones.
Fever and night sweats: Common in cases of leukemia and other cancers.
Enlarged lymph nodes or spleen: In certain types of leukemia, organs like the spleen and lymph nodes may swell.

Metamyelocytes are immature white blood cells (WBCs) typically found in the bone marrow, where they develop into mature granulocytes (e.g., neutrophils). These cells are more mature than myelocytes and should mature into fully functional neutrophils within the bone marrow. Under normal conditions, metamyelocytes should not be present in the peripheral blood. When metamyelocytes appear in the blood, it's often a sign that your body is fighting an infection, or responding to other changes inside your body.

Testing for the presence of absolute metamyelocytes is usually done as part of a complete blood count (CBC) with differential, especially when there is suspicion of bone marrow stress or an underlying blood disorder. The absolute metamyelocytes test measures the number of metamyelocytes circulating per microliter (uL) or liter of blood. It can provide insight into how the bone marrow responds to infection, inflammation, or other stressors.

Abnormal Absolute Metamyelocytes

Abnormal (Elevated)Absolute Metamyelocytes - Causes

Infections: Severe or systemic bacterial infections (e.g., sepsis) can cause a "left shift," where immature forms of white blood cells, including metamyelocytes, are released into the bloodstream.
Bone marrow disorders
Myeloproliferative disorders: Conditions such as chronic myelogenous leukemia (CML) can cause the release of immature white blood cells, including metamyelocytes, into the bloodstream.
Myelodysplastic syndromes: The bone marrow produces abnormal cells, leading to immature cell release.
Chronic inflammatory diseases: Conditions such as rheumatoid arthritis or systemic lupus erythematosus (SLE) can result in bone marrow hyperactivity, producing immature granulocytes.
Severe anemia or hypoxia: The bone marrow compensates by increasing blood cell production, causing the release of immature forms like metamyelocytes into circulation.
Bone marrow-stimulating drugs: Medications like granulocyte colony-stimulating factor (G-CSF), used in cancer patients or those with neutropenia, can stimulate the bone marrow to release immature white blood cells.
Acute blood loss: Severe hemorrhage can stimulate rapid bone marrow response, causing the release of metamyelocytes as the body attempts to compensate.
Tissue damage or trauma: Major physical trauma, burns, or surgeries may cause an increase in metamyelocytes due to increased white blood cell production in response to tissue injury.
Leukemias: Certain types of leukemia, particularly acute and chronic myeloid leukemia, can cause excessive production of immature cells like metamyelocytes.

Abnormal (Elevated)Absolute Metamyelocytes - Symptoms

Since metamyelocytes in the blood usually indicate an underlying condition, symptoms depend on the cause of the abnormal levels. Common symptoms associated with elevated metamyelocytes include:

Infections: Fever, chills, body aches, fatigue, and signs of localized or systemic infection.
Bone marrow disorders: Fatigue, unexplained bruising, frequent infections, bleeding, and weight loss.
Anemia: Fatigue, weakness, pale skin, dizziness, shortness of breath.
Chronic inflammation: Joint pain, swelling, chronic fatigue, and low-grade fever.
Leukemia: Persistent fatigue, weight loss, easy bruising, frequent infections, swollen lymph nodes.

Myelocytes are immature white blood cells that develop in the bone marrow and then mature into white blood cells, such as neutrophils, eosinophils, and basophils. They are not normally found in the bloodstream in significant numbers

The lab test for myelocytes typically involves counting the number of myelocytes per 100 white blood cells (WBCs) seen under a microscope.

Testing for myelocytes in the bloodstream is usually evaluated as part of a complete blood count (CBC) with differential or a bone marrow biopsy. The test is useful in identifying bone marrow activity, particularly when immature white blood cells are released into circulation as a response to stress, infection, or malignancy.

Abnormal Myelocyte Results

Myelocytes in the Blood - Causes

Myelocytes are usually found in the bone marrow. However, when detected in the blood, it suggests an abnormal release of immature WBCs. Causes of elevated myelocytes include:

Infections: Severe or systemic bacterial infections, especially in cases of sepsis, can cause the bone marrow to release immature white blood cells like myelocytes.
Bone marrow disorders
Chronic myeloid leukemia (CML): A type of blood cancer that leads to the overproduction of immature granulocytes.
Myelodysplastic syndromes (MDS): These conditions cause abnormal production of blood cells in the bone marrow.
Leukemias: Both acute and chronic myelogenous leukemias may cause high levels of immature WBCs, including myelocytes, to be released into the blood.
Severe inflammation or inflammatory diseases: Chronic inflammatory conditions such as rheumatoid arthritis or inflammatory bowel disease may cause the bone marrow to release immature white blood cells.
Stress or trauma: Physical trauma, major surgeries, burns, or severe stress on the body can cause increased white blood cell production, leading to myelocytes appearing in the blood.
Severe anemia: Hemolytic anemia or significant blood loss may cause the bone marrow to overcompensate, releasing immature cells like myelocytes.
Medications or therapies: Certain treatments, like chemotherapy or granulocyte colony-stimulating factor (G-CSF), can stimulate the bone marrow to release myelocytes into the bloodstream.

Elevated Myelocytes - Symptoms

Elevated myelocytes are not a disease, but are a sign of an underlying condition. Symptoms will depend on the primary cause:

Infection symptoms: Fever, chills, fatigue, and signs of localized or systemic infection.
Bone marrow disorders/leukemia: Fatigue, unexplained bruising or bleeding, frequent infections, swollen lymph nodes, and weight loss.
Chronic inflammation: Joint pain, swelling, and low-grade fever in conditions like rheumatoid arthritis.
Anemia symptoms: Pale skin, dizziness, fatigue, and shortness of breath in cases of severe anemia.

This test measures the absolute number of myelocytes in a specified blood volume.

Elevated Absolute Myelocytes

Elevated Absolute Myelocytes - Causes

Elevated absolute myelocytes, known as a 'left shift', usually occur due to stress on the bone marrow or a response to certain underlying conditions:

Severe bacterial infections: In cases of severe infection, such as sepsis, the bone marrow may release immature cells like myelocytes into the bloodstream to meet the increased demand for white blood cells.
Bone Marrow Disorders
Chronic myeloid leukemia (CML): A type of blood cancer characterized by an overproduction of immature white blood cells, including myelocytes.
Myeloproliferative disorders: These conditions lead to excessive production of various blood cells, including myelocytes.
Myelodysplastic syndromes (MDS): A group of disorders caused by dysfunctional blood cell production, which may lead to immature white blood cells, like myelocytes, entering the bloodstream.
Chronic inflammatory conditions: Chronic conditions, such as Rheumatoid Arthritis, Systemic Lupus Erythematosus (SLE), or Inflammatory Bowel Disease (IBD) can stimulate the bone marrow to release immature white blood cells like myelocytes.
Severe anemia (hemolytic anemia or aplastic anemia): Severe anemia, especially if caused by blood loss or destruction of red blood cells, may prompt the bone marrow to overcompensate by releasing immature cells into circulation.
Physical stress or trauma (burns or surgery): Significant physical stress can stimulate the bone marrow to release immature cells like myelocytes as part of the body’s response to injury.
Medications or treatments: Chemotherapy or use of Granulocyte Colony-Stimulating Factor (G-CSF), often given to stimulate white blood cell production in patients undergoing cancer treatment or with neutropenia, can cause the release of myelocytes into the bloodstream.
Leukemias and other hematologic cancers: Both acute and chronic leukemias (e.g., Acute Myeloid Leukemia (AML) and Chronic Myeloid Leukemia (CML)) may result in a significant increase in myelocytes and other immature white blood cells in circulation.

Elevated Myelocytes - Symptoms

The presence of myelocytes in the peripheral blood is typically an indicator of an underlying condition. Symptoms vary depending on the cause:

Infection symptoms: Fever, chills, fatigue, and signs of infection such as localized pain, swelling, or systemic signs of sepsis.
Bone marrow disorders or leukemia: Fatigue, easy bruising, frequent infections, swollen lymph nodes, bone pain, unexplained weight loss, and night sweats.
Anemia symptoms: Pale skin, fatigue, dizziness, shortness of breath, and weakness due to reduced red blood cell count.
Chronic inflammation: Joint pain, swelling, and stiffness in autoimmune diseases like rheumatoid arthritis.
Physical stress or trauma: Symptoms related to injury, burns, or major surgery, such as pain, swelling, or decreased function.

Promyelocytes are an early stage of white blood cells (specifically granulocytes) found in the bone marrow. They are precursors to more mature forms of white blood cells like neutrophils, eosinophils, and basophils. In healthy individuals, promyelocytes should be present only in the bone marrow, not in the bloodstream. Promyelocytes in a blood sample are abnormal and typically indicate a disruption in normal blood cell production. The detection of promyelocytes usually occurs as part of a complete blood count (CBC) or bone marrow biopsy when investigating abnormal blood cell production, anemia, or blood cancers.

The promyelocytes per 100 white blood cells blood test measures the percentage of total white blood cells or bone marrow cells that are promyelocytes. It provides a proportion of these cells relative to the overall white blood cell count. This test is used clinically for:

Bone marrow evaluation: When evaluating bone marrow function or disorders, this test helps determine if promyelocytes are present in excessive proportions, which would indicate a problem in blood cell maturation.
Diagnostic clarity: An increased percentage of promyelocytes in a bone marrow test (normally 1-5%) might indicate the early stages of diseases like AML, where the bone marrow produces large numbers of immature cells.
Peripheral blood: If promyelocytes are found in the bloodstream (where they normally should not be), a percentage can be given to evaluate how much of the white blood cell population is made of these immature forms, potentially indicating a serious blood disorder.

Abnormal Promyelocyte Levels

Causes of High Promyelocyte Levels

Acute promyelocytic leukemia (APL): This subtype of acute myeloid leukemia (AML) is characterized by an abnormal accumulation of promyelocytes in the bone marrow and peripheral blood. APL is the most common cause of high promyelocyte levels in the blood.
Other types of acute myeloid leukemia (AML): Besides APL, other types of AML can also lead to increased promyelocyte levels.
Bone marrow disorders: Conditions like myelodysplastic syndromes (MDS), which affect the bone marrow’s ability to produce healthy blood cells, may also cause an increase in promyelocytes.
Bone marrow stress: In some rare cases, conditions like severe infections or significant bone marrow stress (e.g., from chemotherapy or radiation) can lead to elevated promyelocytes as the bone marrow tries to produce more cells quickly.

High Promyelocyte Levels - Symptoms

Symptoms associated with high promyelocytes generally relate to underlying conditions, such as APL or AML. Common symptoms may include:

Fatigue and weakness - due to anemia (low red blood cell counts)
Frequent infections - due to reduced normal white blood cells
Bruising or bleeding - due to low platelet counts, which may present as frequent nosebleeds, easy bruising, or heavy menstrual bleeding
Bone pain - caused by the overcrowding of abnormal cells in the bone marrow
Shortness of breath
Paleness or pallor
Unexplained weight loss
Fever or night sweats

Prostate-Specific Antigen (PSA) is a protein produced by the prostate gland, a small gland in men that creates fluid for sperm.

This test measures the total amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced by cells in the prostate gland. The test is often used to screen for prostate issues, including prostate cancer, but keep in mind, that higher PSA levels can also be due to less serious conditions like an enlarged prostate, an infection, as well as inflammation or trauma to the prostate, such as following a biopsy or colonoscopy.

Factors Lowering PSA Levels

For men who are thinking about being screened for prostate cancer, it’s important to talk to your doctor about anything you’re taking that might affect your PSA level, as it might affect the accuracy of your test result. Some things that might lower PSA levels (even if a man has prostate cancer) include the following:

5-alpha reductase inhibitors: Certain drugs used to treat BPH or urinary symptoms, such as finasteride (Proscar or Propecia) or dutasteride (Avodart), can lower PSA levels. These drugs can also affect prostate cancer risk. So, tell your doctor if you are taking one of these medicines as they can lower PSA levels. The doctor might need to adjust for this.
Herbal mixtures: Some mixtures sold as dietary supplements might mask a high PSA level. So it’s important to let your doctor know if you are taking any dietary supplements, even ones that are not necessarily meant for prostate health. Saw palmetto (an herb used by some men to treat BPH) does not seem to affect PSA.
Certain medicines: Some research has suggested that long-term use of certain medicines, such as aspirin, statins (cholesterol-lowering drugs), and thiazide diuretics (such as hydrochlorothiazide) might lower PSA levels. More research is needed to confirm these findings.

Elevated PSA Levels

Elevated levels of PSA have been associated with benign and malignant prostatic disorders. Studies indicate that in men 50 years or older measurement of PSA is a useful addition to the digital rectal exam in the early detection of prostate cancer. In addition, PSA decreases to undetectable levels following complete resection of the tumor and may rise again with recurrent disease or persist with residual disease.

Elevated PSA Levels - Causes

Benign prostatic hyperplasia (BPH): Non-cancerous enlargement of the prostate.
Prostatitis: Inflammation or infection of the prostate.
Prostate cancer: Elevated PSA can be a sign of prostate cancer, although it is not definitive.
Urinary tract infections (UTIs): Can temporarily increase PSA levels.
Recent ejaculation or prostate stimulation: Sexual activity or certain medical procedures can elevate PSA levels temporarily. This is why some doctors suggest that men abstain from ejaculation for a day or two before testing.
Age: PSA levels can naturally increase with age.
Riding a bicycle: Some studies have suggested that cycling may raise PSA levels for a short time (possibly because the seat puts pressure on the prostate), although not all studies have found this.
Certain urologic procedures: Some in-patient procedures, such as a bladder exam, prostate biopsy, or cystoscopy, can affect the prostate and raise PSA levels for a short time. Some studies have suggested that a digital rectal exam (DRE) might raise PSA levels slightly, although other studies have not found this. As such, if both a PSA test and a DRE are being done during a doctor visit, some doctors advise having the blood drawn for the PSA before having the DRE, just in case.
Certain medicines: Taking male hormones like testosterone (or other medicines that raise testosterone levels) may cause a rise in PSA.
Warmer climates

Elevated PSA Levels - Symptoms

Often asymptomatic, especially in early stages.
Possible urinary symptoms, such as:
Frequent urination, especially at night
Difficulty starting or stopping urine flow
Weak or interrupted urine stream
Pain or burning during urination
Pain or discomfort in the pelvic area
Blood in the urine or semen (in advanced cases)

Amylase is an enzyme produced by the pancreas and salivary glands that helps in the digestion of carbohydrates. It breaks down complex carbohydrates into simpler sugars like glucose, which can be easily absorbed by the body. This process is essential for proper digestion and nutrient absorption.

The amylase test is primarily used to help diagnose pancreatitis, a condition in which the pancreas becomes inflamed. When the pancreas is inflamed, it can leak amylase into the bloodstream, which can cause the levels of amylase in the blood to rise.

The amylase test may also be used to:

Investigate the cause of abdominal pain.
Monitor the course of treatment for pancreatitis.
Investigate other conditions that can affect the pancreas, such as peptic ulcer disease, salivary gland inflammation, or macroamylasemia (a condition in which amylase is bound to other proteins in the blood, which can lead to falsely elevated amylase levels).

Abnormal Blood Amylase Levels

Low Amylase - Causes

Pancreatic insufficiency: Conditions like cystic fibrosis or chronic pancreatitis can cause low amylase production.
Liver disease: Severe liver disease can reduce amylase levels.
Cystic fibrosis: This genetic condition often affects the pancreas, leading to low amylase production.
Advanced pancreatic cancer: In some cases, the pancreas may produce less amylase as the disease progresses.
Liver disease: Liver dysfunction can impact the production and release of amylase, leading to low levels in the blood.
Metabolic syndrome: Low levels of amylase have been noted with obesity, metabolic syndrome, and diabetes.
Autoimmune disorders: Certain autoimmune conditions, such as Sjogren's syndrome, can affect the salivary glands, leading to decreased amylase levels.
Malnutrition: Inadequate nutrient intake, particularly protein deficiency, can affect the production of amylase and other digestive enzymes.

Low Amylase - Symptoms

Digestive issues: Poor digestion, bloating, and diarrhea due to insufficient enzyme production.
Fatigue: General weakness and lack of energy.
Weight loss: Unintended, due to malabsorption of nutrients.

High Amylase - Causes

Acute pancreatitis: Pancrease inflammation causing a sharp increase in amylase.
Chronic pancreatitis: Long-term inflammation can raise amylase levels, though less so than acute pancreatitis.
Pancreatic cancer: Tumors can cause elevated levels.
Gallbladder disease: Conditions like cholecystitis or gallstones can lead to higher amylase.
Kidney failure: Reduced clearance of amylase by the kidneys can cause elevated blood levels.
Gastrointestinal conditions: Peptic ulcers or intestinal blockage can lead to higher amylase.
Salivary gland disorders: Conditions such as mumps can raise amylase levels due to inflammation of the salivary glands.

High Amylase - Symptoms

Abdominal pain: Often sharp and concentrated in the upper abdomen, possibly radiating to the back.
Nausea and vomiting: Common, particularly in acute pancreatitis.
Fever: Accompanying symptoms in cases of infection or inflammation.
Loss of appetite: Due to digestive discomfort.
Swelling or tenderness in the abdomen: Especially around the pancreas.

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