Neutropenia

Neutropenia refers to a low level of white blood cells. Because chemotherapy kills both cancerous cells and other normal cells that grow at a fast rate, white blood cells are often destroyed.

Because white blood cells play an important role in preventing infection, any time your white blood cell count drops you are at high risk of getting infection. What’s more, as these cells also help to fight off infections once they are in the body, it is harder to get over an infection when your white counts are low. Therefore you must do everything that you can to decrease the chance that you will become infected while you are receiving chemotherapy.

Normal white blood cell counts are usually in the range of 4,500 – 11,000 per mm³ of blood. After receiving chemotherapy, your white count may drop as low as 200 to 500 per mm³. While you are receiving chemotherapy your white blood cell count will be checked.

Any time that your white blood cell count drops below 1,000 per mm³, you are considered neutropenic. A nurse will review with you special steps that you must take in order to decrease the chance that you will get an infection. These are called neutropenic precautions.  For a  more detailed discussion of neutropenic precautions, click here.

Why are white blood cells important to me?
White blood cells protect your body by resisting and fighting off the germs that cause infection.  White blood cells need to be mature and sufficient in number to work properly.  If your white blood cells are immature or low in number, you may be at an increased risk of getting an infection.

What can be done to treat neutropenia?
Neutropenia as a side effect to chemotherapy or radiation therapy is most commonly temporary, and as the effects of treatment wear off, your bown marrow will begin producing new cells.  As a result, the number of white blood cells in your body will increase to a normal level in approximately two to four weeks.  Medications, such as Neupogen or Neulasta, may also be indicated to assist in increasing your white blood cell counts.

What will my nurse do to check for infection?
Each day that you are in the office for a treatment, your nurse will be checking for any signs of infection by:

• Taking your temperature;
• Listening to your lungs;
• Looking at your mouth;
• Asking about your bowel movements; and,
• Finding out how you feel.

What can be done if I get an infection?
In the event that you get an infection of any kind, there are several actions your doctor may take depending upon the type and severity of the infection, including:

• Taking a blood sample to monitor the blood counts and obtain a culture of the infection;
• Ordering a chest X-ray;
• Examining a urine sample for germs;
• Starting you on intravenous (IV) antibiotics to fight off the germs in your body;
• Checking your mouth and listening to your lungs; and,
• Ordering Tylenol if your temperature is too high.

If your doctor feels it is necessary for you to be hospitalized while you are being treated for an infection, your nurse at the hospital may take various actions to assist in eliminating the infection, such as:

• Taking your temperature at least every four to eight hours;
• Starting you on intravenous (IV) antibiotics to fight off the germs in your body;
• Giving you oral antibiotics;
• Helping you to follow restrictions (outlined in Neutropenic Precautions);
• Encouraging you to drink plenty of fluids and to keep active;
• Encouraging you to eat a well-balanced diet; and,
• Taking care of your IV site and dressing and your Infuse-A-Port if you have one.