A lowered level of immunity is called immunosuppression. Certain diseases, including cancer, and certain treatments, including chemotherapy and radiation therapy, can cause some people to have immunosuppression. This is usually referred to as having a low white blood cell count, but you might hear other words to describe it too. Show
What is neutropenia?Neutropenia is defined as a lower than normal number of neutrophils (a type of white blood cells). White blood cells are part of the immune system. There are different types of white blood cells, and they each have a key role in the body’s defense against germs:
Neutrophils are key infection-fightersNeutrophils form a very important defense against most types of infection. Normally, most of our white blood cells are neutrophils. In patients with cancer, neutropenia is usually caused by treatment. When looking at your risk of getting an infection, doctors look at the number of neutrophils you have. If your neutrophil count is low, the doctor may say you are neutropenic. For most people with cancer, having a low neutrophil count is the biggest risk factor for getting a serious infection. Ask your doctor if your cancer treatment will cause your neutrophil count to drop. Lymphocytes can mark, signal, and destroy germsSome treatments, most often those given during a bone marrow (stem cell) transplant, can cause a shortage of lymphocytes. B and T lymphocytes help fight viruses, but have different jobs:
Monocytes and macrophages help recognize invaders
What is an absolute neutrophil count (ANC)?You might hear your doctor or nurse talk about your absolute neutrophil count or ANC. This is the number of neutrophils you have in a certain amount of blood. Your health care team will use your ANC to get an idea of how well your immune system might work during treatment. A blood test called a complete blood count (CBC) is used to see how well your immune system is working. It measures your white blood cells (WBCs), and your cancer care team is able to figure out your ANC from your WBC count. Your cancer care team will use your ANC to get an idea of how your immune system is affected by treatment and how well it is working to protect you from infection. As the ANC gets lower, the usual signs of infection, such as fever, pus, pain, swelling, and redness, may not show up when an infection starts. This is because these signs are caused by neutrophils fighting off germs, and if you don’t have enough neutrophils to fight infection, you won't produce the signs. This can make it hard to know if you have an infection. The good thing is that another WBC, called the monocyte, can still cause signs of infection in a person who has neutropenia. Sometimes in people with severe neutropenia a fever may be the only sign of an infection. The lower your ANC is and the longer it stays low, the higher your risk of infection will be. Ask your doctor if your cancer treatment might cause your neutrophil count to drop. Your cancer care team will help you find the ANC on your lab results and can help explain more about it. What can cause or increase the risk for neutropenia?
Symptoms of neutropenia
Problems neutropenia might cause
Treatment of neutropeniaTreatment may include one or a combination of the following:
Talk to your cancer care team about what to watch for. Call your doctor if you have a fever (your cancer care team will let you know what temperature they consider a fever) or any other symptoms of neutropenia. Is low white blood count serious?A low white blood cell count is a consequence of serious diseases, and it can lead to harmful health problems—including infections, slow healing, and cancer. A low white blood cell count doesn't cause symptoms, but the complications of a low white blood cell count can cause many different symptoms.
What causes WBC levels to be low?Low WBC counts are often linked to bone marrow problems. Being around certain chemicals, like benzene and pesticides, as well as some types of cancer and cancer treatments including chemotherapy and radiation, can hurt your bone marrow's ability to make WBCs.
What happens when your WBC is too low?Without enough white blood cells, including enough neutrophils, you're more vulnerable to developing infections. A white blood cell count that's less than 4,000 cells per microliter of blood is a low white blood cell count. Normal white blood cell counts vary depending on age and sex.
Should I be worried about low white blood cell count?The main risk of an abnormally low white blood cell count is how vulnerable it may make a person to infection. Without an adequate white blood cell response available to fight infection, the body is at greater risk that any infection (including those usually regarded as minor) may cause serious illness or death.
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