Cancer-Related Neutropenia: Causes and Effects on White Blood Cells
Treatment for the cancer requires chemotherapy or Immunotherapy at some point. While these treatments help to kill cancer cells, they may lower the neutrophils in cancer patients. While it may sound worrying, with the right management and care, it can be resolved easily.
This article helps you to know about the causes behind the low neutrophil count, what signs to look for, and how to protect yourself while staying on your cancer journey.
Overview: What is Neutropenia?
Neutropenia is also referred to as a Low neutrophil count, a condition that may be caused by a genetic condition, infection, or as a side effect of cancer treatment. Neutrophils are produced by Bone marrow cells and help fight bacterial and viral infections; a significantly low neutrophil count can compromise immunity, which increases the risk of severe infections.
What is the Normal range of Neutrophils in our body?
A normal neutrophil count generally ranges approximately. Between 2500-7000 microliters (µL) of blood, depending on the age and health condition. A count lower than 2500 could indicate neutropenia. For adults, the lowest normal limit lies around 1200 µL/L. Here is the range for neutropenia given below.
- Mild Neutropenia—~1000-1500 µL
- Moderate Neutropenia—~500-1000 µL
- Severe Neutropenia—Below 500 µL
Symptoms and Causes: What are the Symptoms of Neutropenia?
Neutropenia makes your body susceptible to infections; its symptoms can only be seen if you have repeated infections or are undergoing cancer treatment therapies. Symptoms include:
- High chill fever
- Anxiety and Fatigue
- Chest pain
- Dizziness or lightheadedness
- Sore throat
- Coughing and shortness of breath
- Mouth ulcers or around the anus
- Burning or frequent Urination
- Diarrhea
What are the causes of Neutropenia?
Here are some of the risk factors that can lead to neutropenia
- Cancer treatment—Cancer treatment techniques like Chemoradiation may affect the neutrophil level in blood or bone marrow, which makes the neutrophil count low in blood. The drop is usually seen 7-14 days after the treatment.
- Congenital Neutropenia (Genetic Factors)—Some people are born with a genetic condition that can affect the neutrophil count. Certain genetic conditions, like Kostmann syndrome and cyclic neutropenia, are usually rare when a neutrophil count from the body is low from birth.
- Bone Marrow Disorders—Certain Bone marrow disorders and cancers like Leukemia, lymphoma, and aplastic anemia directly affect the bone marrow, which affects the production of neutrophils, leading to neutropenia.
- Certain Medications—Medications like antibiotics (penicillin), antipsychotics, antithyroid, and antiviral medications can affect the Neutrophil count in blood. In some cases, the body may develop an immune reaction against neutrophils caused by these drugs.
- Autoimmune Conditions: Certain Autoimmune disorders, such as arthritis, SLE(Systemic Lupus Erythematosus), can sometimes attack our immune cells, like neutrophils or Bone marrow, which may lead to a low Neutrophil count, increasing the risk of infection.
- Deficiency in diet: A Diet deficient in essential nutrients like Vitamin B12, folate, and copper can affect the bone marrow’s ability to produce immune cells (neutrophils), or prolonged malnutrition may lead to neutropenia.
- Certain Infections: Viral, bacterial, and parasitic infections can directly affect the neutrophils. Some of the Common diseases include Hepatitis, Lyme disease, Tuberculosis, and HIV.
How to Diagnose Low Neutrophil Count?
Neutropenia is diagnosed through a combination of blood tests, medical examination, and bone marrow evaluation. Your provider may ask you about the symptoms as part of a routine body examination.
What are the Tests for Neutropenia?
Some of the tests for Neutropenia are:-
Complete blood count (CBC) blood test: This test looks for the complete blood cells in the body, including the neutrophils. If the Absolute Neutrophil Count(ANC) is found to be below 1500 cells/mm³, it’s considered Neutropenia.
Some of the additional Tests include
- Viral test—HIV, hepatitis
- Autoimmune markers for an autoimmune condition like arthritis, SLE, Vitamin B12, or Folate test.
- Genetic Testing—To check for congenital conditions.
- Biopsy (Bone Marrow)—If your healthcare provider is unsure about what is causing neutropenia, they may take a sample of your bone marrow for microscopic examination to check for bone marrow damage or other conditions.
Treatment: How to Treat Neutropenia?
Some types of neutropenia do not require any treatment, but some do, depending on the cause of neutropenia. Here are some of the treatment options.
- Treating the Underlying Cause: If your neutropenia is caused by infection, medication, or other illness, treating that cause will help you to control neutropenia
- Antibiotics or Antifungals: In case you have neutropenia with Fever(Febrile Neutropenia) or any infection.
- Growth factors (G-CSF): This drug is usually prescribed after Chemotherapy or stem cell transplant to promote the level of neutrophils affected by these therapies. Examples include Filgrastim and Pegfilgrastim.
- Steroids or immunosuppressant drugs: In case neutropenia is caused by an autoimmune condition, your provider may give you these drugs to calm the immune system.
- STEM cell transplant: In case of inherited neutropenia, your doctor may suggest a stem cell or bone marrow transplant.
Management and Prevention
Neutropenia can be managed easily at home with some precautions and by adopting good practices. In case you are born with Neutropenia (genetic cause), you cannot prevent it.
Here are some tips to manage and prevent the risk of getting neutropenia.
- Always do the regular monitoring if you have a low neutrophil count through blood tests like the CBC test and the Absolute neutrophil count (ANC) test.
- Regularly wash your hands and avoid crowded places, always wash the vegetables and fruits before consuming, and use protective masks in high-risk areas if needed.
- Review your medication if neutropenia is caused by drugs; consult with your doctor about the drug if required.
- Manage condition. if you have an autoimmune condition, Vitamin deficiencies (B12, folate) can help you restore the neutrophil level.
- Eating a healthy and balanced diet, getting enough rest, and staying physically active can prevent you from getting neutropenia.
- Take prophylactic medicines prescribed by your doctor to prevent infections.
- You may take the recommended vaccines to avoid conditions like Pneumonia and, flu to prevent such types of infection.
A final thought
Neutropenia can be treated easily by knowing the exact cause and experience of the person having it. In case you have an infection, your neutrophil count may differ, and the number will likely return to the normal level with time and recovery, but if you are undergoing Chemotherapy or have an autoimmune or chronic condition, your neutrophil level may be severely down, which means it requires medical attention to recover. Consult with your health care provider about the condition and adopt the best treatment methods, like Immunotherapy from the best cancer hospital, to get minimal risk during cancer treatment, and be sure to go for frequent checkups to monitor the level and take medications if required to remain infection-free.
