What is neutropenia and how is neutropenia and chemotherapy interrelated? To explain in simple terms, a condition where neutrophils are killed by chemotherapy drugs during any chemotherapy treatment is referred to as neutropenia. Neutrophils are the white blood cells that fight infections in the body. Neutrophils constitute a major portion of the circulating white blood cells in the blood. It comprises of approximately 50 to 70 percent of the white blood cells. Neutrophils only stay in the blood for a day and therefore it needs to be continuously replaced. It is naturally replaced in our body with the help of bone marrow. Every hour the tender centre portion of most of the bones produce around 10 billion neutrophils. If the bone marrow is unable to produce adequate neutrophils or if they are destroyed at a faster rate than they are produced it results in neutropenia which means lack of neutrophils.

How is Neutropenia and Chemotherapy Interrelated?

Neutrophils’ major function is to protect the body from any possible infections and also to prevent the body from developing any infection. They look out for the bacteria in the blood and then destroy them to save the body from infections. In case of infections, a healthy person is capable of being supported by neutrophils without the use any medication or antibiotics as the bone marrow produces it at a faster rate to fight against the bacteria. However, a patient undergoing chemotherapy suffers from low white blood cell count. This is because chemotherapy is too harsh on the body affecting the production of white blood cells.

Besides neutrophils the outer lining of the body or the mucous membranes also protect the body against infections. It is very easy for it to be affected during the process of chemotherapy. Chemotherapy treatment involves the use of IV lines, needles and catheters, consequently providing opportunities for bacteria to seep through the skin very easily. Lack of neutrophils or white blood cells could cause infections in the lungs, sinuses, blood, throat, mouth and skin. Some of the common symptoms of neutropania are high grade fever, shortness of breath, rashes, cough, diarrhea, sore throat, blood in urine and burning sensation with urination, swelling and redness around an injury or around skin punctures used for an IV line etc.

Can Chemotherapy be continued if diagnosed with Neutropenia?

If any of the above mentioned symptoms are noticed in a patient undergoing chemotherapy, the doctor would advise a diagnosis for Neutropenia. A complete blood count would be taken to determine the white blood cell count. Such counts are taken both before and after the chemotherapy. The normal count of white blood cells should range between 4000 to 10000 white blood cells in one cubic millimeter. Another important factor to check is to check the absolute neutrophil count. Neutrophil count is always slightly lower than the total white blood cells count. Noermally, it should range anywhere between 2500 to 6500 neutrophils in one cubic millimeter. Depending on the absolute neutrophil count, neutropenia can be classified into three degrees namely, mild, moderate and severe. Absolute neutrophil count between 1000-1500 falls in the mild category which means that risk of infection is minimal. A count between 500-1000 falls in the moderate category which means that there is a moderate risk of infection. And lastly, a count less than 500 suggests that the risk of developing infection is very high.

During chemotherapy treatment, if the absolute neutrophil count is found to be less than normal or moderate then the chemotherapy treatment is altered to suit the person’s body. In such cases, the chemotherapy cycle could be delayed or the chemotherapy regime may be changed along with lower dosage as compared to before. A change in the chemotherapy treatment may reduce its effectiveness and as a solution the doctor may suggest the patient to continue with chemotherapy along with the use of medications to increase the production of neutrophils in the bone marrow. Antibiotics and medications could also be given as a preventive measure to avoid the occurrence of neutropenia.

How to Reduce the Risk of Neutropenia during Chemotherapy?

Other than taking preventive antibiotics and other medication, one should also remember top their bit to lower the risk of infection. Given below are some pointers on how the risks of infection can be lowered by doing simple things.

• Avoid crowded places such as theatres and malls
• Wash your hands regularly and make it a practice for other family members as well
• Do not use bar soap when you have to share it with others, use liquid soap instead
• Keep yourself away from those who have any form of infection
• Do not go through any dental work and immunizations without consulting with your doctor
• Eat well cooked food. Especially, avoid undercooked meat, seafood and raw eggs.
• This may be difficult but keep your pets away as they can carry and spread infections easily. Hire someone or ask for the help of a loved one to take care of the pets while you are undergoing chemotherapy.
• Women should use sanitary napkins instead of tampons
• Be careful when cutting nails and do not cut the cuticles

I hope this article has helped you understand the relation between neutropenia and chemotherapy. If you or your loved one are undergoing or are advised to undergo chemotherapy then ensure that all your queries about chemotherapy side effects including neutropenia are cleared by your oncologist / doctor. Any signs of infection should also be reported immediately to the doctor. Take care!