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TOPICS
Low White Count (Neutropenia) | Resources | Research News |
Also see Infections and Neutropenia and Low Blood Counts
In the News
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Br J Cancer. 2009 September:
Prevention of febrile neutropenia: use of prophylactic antibiotics
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Support Care Cancer. 2010 May: Prophylaxis of chemotherapy-induced febrile neutropenia with granulocyte colony-stimulating factors: where are we now?
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Medscape: Late Onset Neutropenia (LON) following Rituxan therapy - incidence, risk factors, and possible mechanisms medscape.com
"... the median onset of LON after discontinuation of rituximab treatment varies between 56 and 175 days, with a median duration of neutropenia from 6 to 77 days,[7–14] whereas the median duration of treatment before onset of neutropenia in other drug-induced neutropenias ranged from 2 days to 2 months and normalization of neutrophil count occurred after 4–24 days. |
Overview
Neutropenia is the lowering of the white blood cells that fight infections. This condition is an expected complication of chemotherapy, which often impairs bone marrow cells that produce specialized blood cells. This condition is most severe in patients who receive aggressive treatments. Neutropenia may also be caused by autoimmune conditions.
"Neutropenia is usually characterized by a reduced number of blood neutrophils, although a reduced number of lymphocytes, monocytes, eosinophils, or basophils may also contribute to the decreased total cell count. Neutropenia accompanied by monocytopenia and lymphocytopenia is often a more serious disorder than neutropenia alone." Merck Manual
White Blood Cells ~ click to enlarge
Important:
"Neutropenia you might not even feel. You might not even know that you have a low white count unless, of course, we draw your blood and call you on the telephone. ... But from a life-threatening point of view, we want to prevent you from having an infection. That's why we really want to educate you about what to do during times of low white blood counts."
- Paula Anastasia, RN, MN, AOCN - Oncology Nurse Educator.
Tips for preventing problems associated with low white count:
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Avoid people and places that will expose you to illness or bacteria - such as public places.
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Wash your hands often.
Keep your unwashed hands away from ALL mucous membranes, especially the nose, eyes, and mouth. You are more likely to catch a cold through your nose than your mouth because saliva contains a lot of bacteria-killing enzymes.
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Clean often.
One thing that I do that surprises a lot of people is "lysoling" the phone and the steering wheel of your car. Lots of germs there. Plenty of rest, juice, washing hands at appropriate times, etc. I also carry antibiotic hand wash but I don't use it too often - it's not supposed to be that good for you but in emergencies when I have been out (subway, etc) and can't wash hand, I'll use it. -Ronnie in CT
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See Diet for Immunosuppressed Patients
Patients receiving chemotherapy and radiotherapy may have compromised immunity.
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Do not purchase products older than the pull date. Read labels.
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Store and handle properly foods to avoid food-related infections and illness.
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Avoid moldy, spoiled and outdated food products.
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Replace dish and face towels after each use.
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Thoroughly wash produce; cooking fruits and vegetables is best. Use vinegar to clean vegetables, and/or mild soap.
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Beware of foods that have been "double-dipped."
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Ask your doctor about Neupogen® for treatment of prevention of low white counts.
See biologics
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Resources
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 Managing Neutropenia - Topic Search: Scholar | PubMed
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Br J Cancer. 2009 September:
Prevention of febrile neutropenia: use of prophylactic antibiotics
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NEW: Arthritis Res Ther. 2005: Primary and secondary autoimmune neutropenia
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Support Care Cancer. 2010 May: Prophylaxis of chemotherapy-induced febrile neutropenia with granulocyte colony-stimulating factors: where are we now?
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Fungal Infection See PAL
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Neutropenia
Quick Reference
(Low White Count)
Makes you susceptible to infection: fungal, viral, bacterial
Total white cells:
4-11(x109/l)
Neutrophils:
2-8 (x106/l)
Normal range may vary for different labs
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