Left Shift of Neutrophils
Left Shift of Granulocytes
Left shift refers to increased numbers of circulating neutrophil precursors (band forms, metamyelocytes, myelocytes, promyelocytes or even blasts).
This may be physiologic in response to a stress on the body such as pregnancy, infection or inflammation; it may occur with administration of granulocyte colony stimulating factor (G-CSF); or it may be a sign of bone marrow infiltration.
Causes of Left Shift of Granulocytes
- Pregnancy
- Infection / inflammation
- G-CSF administration
- Bone marrow infiltration - MPNS, leukaemias, lymphomas, myeloma, metastatic cancer
The presence of nucleated red blood cells and left shift is referred to as a leukoerythroblastic blood film. If left shift is present then look for nucleated red cells.
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