Neutropenia (low White Blood Cell Count)

White blood cells play an important role in protecting us from infection. Neutrophils are a type of white blood cell. Neutrophils are our body's first line of defense against infection. They surround and destroy foreign micro-organisms, such as bacteria, to keep us healthy.

It is common for cancer patients to experience low white blood cells, especially those receiving chemotherapy. Chemotherapy can dramatically reduce the number of neutrophils produced by your bone marrow. Having too few neutrophils is called neutropenia. If you have neutropenia, you have an increased risk of infection.

Neutropenia itself does not cause any symptoms. You may only realize that you have neutropenia when your doctor does a routine blood test or when an infection develops.

Of the more common side effects of chemotherapy, neutropenia and infection are the most serious. If your white blood cell count becomes too low, your chemotherapy may need to be reduced or delayed.

Changes or delays to your chemotherapy dose or schedule can change the results of your treatment. If neutropenia is left untreated, it can lead to serious infection. Such infections can even be life-threatening and you may need to stay in the hospital.

Your healthcare team will check to see if you have low white blood cell counts frequently. If your white blood cell counts are too low, they may recommend treatment.

What are the treatment options for neutropenia?

To treat or manage neutropenia your doctor may prescribe treatment with a white blood cell growth factor, also known as a colony-stimulating factor (CSF). CSFs stimulate your bone marrow to make more white blood cells. This will boost your neutrophil count and reduce the risk of infection.

Because neutropenia is serious, it is best to avoid low white blood cell counts whenever possible. If you are at high risk of developing neutropenia your doctor may prescribe a CSF to help avoid this problem.

As with any medication, CSFs are not right for everyone.

CSF's may cause your spleen enlarge and rupture. A ruptured spleen can cause death.

If you have a sickle cell disorder, make sure that you tell your doctor. In patients with sickle cell disorder, severe sickle cell crises have been associated with CSF's. Some cases resulted in death.

People who are taking CSF medications should notify their doctor if they develop upper left abdominal pain or pain at the tip of the shoulder; a lump, bruising or swelling at the injection site that does not go away; or if they experience symptoms of an allergic reaction.

The most common side effect association with CSF medication is aching in the bones and muscles.

Chemotherapy can cause sore mouth or throat. Find out more about mucositis.

What about infection?

You should take care not to develop a fever and/or an infection during chemotherapy, even if you receive a CSF. Learn how to avoid infection and to identify the symptoms of infection. Ask your healthcare team who you should contact in case of fever or infection.

If you have symptoms of fever or infection, call your healthcare team right away, even if it is in the middle of the night. Also, ask for the after hours contact information. If you have a fever, do not take any medicine without checking with your doctor first. It's important to make a decision about treatment after talking to your healthcare team and discussing the benefits or the possibility of any negative effects.