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Side Effect: Low White Blood Cell Count (Neutropenia)

What is Low White Blood Cell Count (Neutropenia)?

Low white blood cell count, also known as leukopenia, refers to a decrease in disease-fighting white blood cells in your body. Neutropenia is a specific type of leukopenia. Neutropenia is a condition where you have a low number of neutrophils, which are a type of white blood cell. Neutrophils play an important role in fighting infections so when their levels drop below a healthy range, it can increase the risk of infection.

What does Low White Blood Cell Count (Neutropenia) look like?

Neutropenia itself doesn’t have visible symptoms. However, if you get an infection because of a low white blood cell count, you might notice the following:

Who gets Low White Blood Cell Count (Neutropenia)?

Neutropenia is a common side effect of cancer treatment as a vast majority of chemotherapy treatments can cause a decrease in the level of neutrophils. Cancers that can directly affect the bone marrow, such as leukemia, lymphoma, or multiple myeloma, can also cause a decrease in neutrophil levels. Patients who are immunocompromised before treatment, such as those living with HIV or those who received an organ transplant, are at an increased risk as are patients over the age of 65.

How to prevent Low White Blood Cell Count (Neutropenia)

If receiving a chemotherapy regimen that has a high risk of neutropenia, medications such as filgrastim (Neupogen®, Nivestym®, Zarxio®) or pegfilgrastim (Neulasta®, Fulphila®, Udenyca®) may be given after each treatment to help stimulate production of neutrophils. It is important to note that these medications may not prevent neutropenia from occurring but may help shorten the duration of neutropenia. In some cases, chemotherapy doses may need to be adjusted to decrease the risk of neutropenia. Although it is difficult to decrease the risk of neutropenia, you can take steps to decrease the risk of developing an infection such as:

How to treat Low White Blood Cell Count (Neutropenia)

If you have a low white blood cell count, your provider might temporarily hold your treatment to give your white blood cells more time to recover. In some cases, filgrastim may be given to help increase your neutrophil count. If an infection develops, they will also order specific medications to treat the infection.

References

1) Crawford J, Dale DC, Kuderer NM, et al. Risk and timing of neutropenic events in adult cancer patients receiving chemotherapy: the results of a prospective nationwide study of oncology practice. J Natl Compr Canc Netw 2008;6(2):109-118

2) Schwartzberg LS, Lal LS, Balu S, et al. Incidence of febrile neutropenia during chemotherapy among patients with nonmyeloid cancer receiving filgrastim vs a filgrastim biosimilar. Clinicoecon Outcomes Res 2018;10:493-500

Created: May 23, 2024 Updated: July 17, 2024