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Neutropenia: Treatment, Procedure, Cost and Side Effects

Last Updated: Jan 17, 2023

What is Neutropenia?

Neutropenia is also referred to as leukopenia, cyclic neutropenia, leucopenia, granulocytopenia. Neutropenia is an abnormally low level of neutrophils. Neutrophils are a common type of white blood cell important to fighting off infections particularly those caused by bacteria.For adults, counts of less than 1,500 neutrophils per microliter Neutropenia can be treated with hematopoietic Growth Factors, granulocyte-colony stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF). These are cytokines (inflammation-inducing chemicals) that are present naturally in the body. These factors are used regularly in cancer treatment with adults and children. The factors promote neutrophil recovery following anticancer therapy of blood are considered to be neutropenia.

For children, the cell count indicating neutropenia varies with age. Neutropenia can be acute (temporary) or chronic (long-lasting). Most cases of neonatal neutropenia are temporary. Antibiotic prophylaxis is not recommended because of the possibility of encouraging the development of multi-drug- resistant bacterial strains. Medical care for patients with neutropenia is mostly supportive and based on the etiology, severity, and duration of the neutropenia. Fever and infections occurring as complications of neutropenia require specific treatment. Surgical care is not usually indicated but may be employed in certain contexts. Sometimes a bone marrow biopsy may be required to diagnose the specific cause of neutropenia.

How is the treatment done?

Approaches for treating neutropenia include Antibiotics for bacterial infections, if the underly-ing cause is an infection.A treatment called granulocyte colony-stimulating factor (G-CSF). This stimulates the bone marrow to produce more white blood cells. It is used for several types of neu-tropenia, including congenital types. This treatment can be lifesaving in these cases.Changing medi-cations, if possible, in cases of drug-induced neutropenia Granulocyte (white blood cell) transfusion Stem cell transplants may be useful in treating some types of severe neutropenia, including those caused by bone marrow problems.

In individuals with neutropenia and Felty syndrome who have recurrent, life-threatening bacterial infections, splenectomy is the treatment of choice, though the response is often short-lived. Systemic lupus associated with autoimmune agranulocyto-sis may also respond to splenectomy or to immunosuppressive therapy. The treatment of neutropenia will depend on the underlying reason for the disorder. Medical treatments to help reduce the impact of neutropenia include:Granulocyte-colony stimulating factor (G-CSF): This is a glycoprotein that stimulates the bone marrow to produce neutrophils and other granulocytes and releases them into the bloodstream. The most commonly used version of G-CSF is a drug called filgrastim. Granulo-cyte-macrophage colony-stimulating factor (GM-CSF): Naturally produced glycoprotein carries out a similar role to G-CSF. Both promote neutrophil recovery after chemotherapy.

Who is eligible for the treatment?

Neutropenia itself often doesn't cause symptoms. In some cases, people only learn they have neutropenia when they have a blood test for an unrelated reason. But people may have other symp-toms from infection or the underlying problem causing the neutropenia.Infections can occur as a complication of neutropenia. They occur most often in the mucous membranes, such as the inside of the mouth and the skin.

These infections can appear as:Ulcers,Abscesses (collections of pus),Rashes,Wounds that take a long time to heal.Fever is also a common symptom of infection.The risk for serious infection generally increases as:Neutrophil count goes down,Duration of severe neu-tropenia gets longer.

Who is not eligible for the treatment?

Some people with neutropenia will feel fatigue. However, neutropenia may not cause any symptoms. Patients usually find out they have neutropenia from a blood test. Or when an infection develops. As a result, your doctor will schedule regular blood tests. These can diagnose neutropenia and other blood-related side effects of chemotherapy.Some people with neutropenia will feel fa-tigue. However, neutropenia may not cause any symptoms. Patients usually find out they have neu-tropenia from a blood test. Or when an infection develops. As a result, your doctor will schedule regular blood tests. These can diagnose neutropenia and other blood-related side effects of chemo-therapy.

Are there any side effects?

Some types of cancer and treatments such as chemotherapy may increase your risk of infec-tion. This is because they lower the number of white blood cells, the cells that help your body to fight infection. During chemotherapy, there will be times in your treatment cycle when the number of white blood cells (called neutrophils) is particularly low and you are at increased risk of infection. Stress, poor nutrition, and not enough sleep can also weaken the immune system, making infection more likely.You will have blood tests to check for neutropenia (a condition in which there is a low number of neutrophils). Medicine may sometimes be given to help prevent infection or to increase the number of white blood cells.

What are the post-treatment guidelines?

Once the treatment is completed ,Wash your hands often and well. Use soap and warm water to wash your hands well, especially before eating. Have people around you wash their hands well too.Stay extra clean. If you have a catheter, keep the area around it clean and dry. Clean your teeth well and check your mouth for sores or other signs of an infection each day. If you get a scrape or cut, clean it well. Let your doctor or nurse know if your bottom is sore or bleeds, as this could in-crease your risk of infection.

Avoid germs. Stay away from people who are sick or have a cold. Avoid crowds and people who have just had a live vaccine, such as one for chicken pox, polio, or measles. Follow food safety guidelines; make sure the meat, fish, and eggs you eat are well cooked. Keep hot foods hot and cold foods cold. You may be advised to eat only fruits and vegetables that can be peeled, or to wash all raw fruits and vegetables very well. Avoiding direct contact with pet waste and washing hands after handling any animals, cleaning any wounds with warm water and soap and using antiseptic to clean the site.

How long does it take to recover?

The type or dose of chemotherapy affects when neutrophil levels drop. Generally, they start to drop about a week after chemotherapy begins. Neutrophil levels reach a low point about 7 to 14 days after treatment. This low point is called the nadir.Your neutrophil count then starts to rise again. However, it may take 3 to 4 weeks to reach a normal level again. At that point, your body is ready for the next round of chemotherapy. If you have had several rounds of chemotherapy, it may take longer for your body to start making healthy levels of neutrophils.


What is the price of the treatment in India?

The cost of treatment for Neutropenia is quite expensive.However, an approximate figure can be determined after consultation is done depending upon the type of treatment required.

Are the results of the treatment permanent?

Neutropenia can be acute (lasting less than three months) or chronic (lasting longer than three months). The condition occurs when the bone marrow does not produce enough neutrophils or an increased number of neutrophils are destroyed in the body. For instance, neutropenia is a common side effect of chemotherapy. Therefore, the results of treatment depend upon the pace of reduction of causes that lead to neutropenia.

Frequently Asked Questions (FAQs)

What is the main cause of neutropenia?

The main cause of neutropenia is chemotherapy.

Does neutropenia mean cancer?

No, neutropenia does not mean cancer.

Can neutropenia be cured?

Yes, neutropenia can be cured.

How is neutropenia managed?

Neutropenia can be managed by making some modifications in chemotherapy doses.

How can I increase my neutrophils?

Neutrophils can be increased by taking antibiotics, WBC transfusion and changing the doses of chemotherapy.

What is the most common cause of neutropenia?

Chemotherapy is the most typical cause of neutropenia.

What type of disease is neutropenia?

Neutropenia occurs when you lack white blood cells.

What is neutrophilic disease?

Neutrophilic diseases are caused due to excessive white blood cells.


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Written ByDr. Sanjaya MishraMD - OncologyOncology
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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