A lower than normal number of neutrophils lower than is called neutropenia. Lower than is severe neutropenia. For a cancer patient, an infection can be life-threatening and requires immediate medical attention. It is a common side effect. The length of time it takes neutrophil counts to drop depends on the dose and type of medicine. Cancers that affect the bone marrow, such as leukemia and lymphoma, can also cause a low level of neutrophils.
Neutrophils are counted as part of the complete blood count CBC test. On most blood count reports, the ANC is already calculated. One section of the lab report will state the total white blood cell WBC count and a "differential," in which each type of white blood cell is listed as a percentage of the total. For example, if the total WBC count is 1, mm3, the differential might appear as:. If counts are low, patients may receive medicine called growth factors.
These drugs are given to increase the number of white blood cells. It is like adding together the number of calves and adults to get a headcount for cattle—bands are the more immature form of segmented neutrophils segs.
However, since neutrophils normally have the largest piece of the pie in terms of total white blood cells, the WBC count is usually also low when the neutrophil count is low. They are the most important WBC in fighting infection. The presence of abnormally small numbers of neutrophils in the circulating blood is called neutropenia. There are differing degrees of neutropenia, depending on how low your ANC goes. When the ANC drops below 1,, there may be some increased risk of infection, so your healthcare provider will keep an eye on your counts very closely.
You are at a much greater risk of infection when the ANC is below Bone marrow normally makes your blood cells , including neutrophils. Life-saving cancer therapies including chemotherapy and radiation may target rapidly growing cells and adversely impact the production of neutrophils—and so a drop in ANC is sometimes an expected side effect.
In some cases, when ANC is expected to become low, or when it is already low, antibiotics may be given to prevent infection. Another drug that may be given is a growth factor— medicine that helps boost your neutrophil production.
Simply having a low WBC count or even a low absolute neutrophil count does not necessarily produce noticeable symptoms. That is why it is so important to be alert to the possibility of symptoms of infection when your neutrophils are depleted. Unfortunately, as the ANC gets lower, many of these signs may not be prominent when an infection starts.
Here are some of the signs and symptoms of infection that you can be vigilant about:. If there is a central venous access device central line or port , check for redness, swelling, pain, or pus at the site, where the tube enters the body.
A person with a low ANC might not have redness or pus, but could still have an infection. If your ANC goes down to 1, or lower and you have a fever, many clinicians take the leap of faith that there is an infection.
Antibiotic treatment is usually started immediately, often before the infection's source has been identified. Then it becomes a process of narrowing down the likely suspects from among the possible infectious pathogens while continuing to treat with the most inclusive therapies. As certain clues emerge, healthcare providers may be able to determine the exact site and cause of the infection and which pathogens may be involved. This may mean that the antibiotic that was given at first will be switched to one that is more tailor-made for the offending germ.
Depression of WBCs, including specifically the neutrophils, is the toxicity of many different anti-cancer therapies. A low ANC can also be a manifestation or sign of the underlying disease, as is the case in some types of blood cancer.
Additionally, a low ANC may occur in the treatment of various other chronic illnesses, such as autoimmune disorders like rheumatoid arthritis.
For instance, one of the treatments for rheumatoid arthritis, tocilizumab, blocks a cell signal known as IL It has been linked to lower ANCs, though decreases in neutrophil counts in patients taking tocilizumab do not appear to be associated with serious infections. Steps are taken to lower the risk of infection. Abnormal or unclear test results can make patients worry, especially if they have been waiting to see them.
Talking to the health care provider who is ordering the tests ahead of time might help; you might want to ask them:. Here are 2 of the most common types of blood tests and what they can tell the doctor about your health: the complete blood count CBC and the chemistry panel.
Blood is made up of water, proteins, nutrients, and living cells. A CBC tells your cancer care team about the cells in your blood. It measures 3 basic types of blood cells:. Each of these cells has a special purpose. And each can be harmed by cancer and cancer treatments. RBCs carry oxygen to and carbon dioxide away from the cells in your body.
The CBC measures red blood cells in many ways, but the simplest measure is either. WBCs fight infection. There are many types of white blood cells and each fights infection in a special way. The most important infection-fighting WBC is the neutrophil.
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