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Last Updated: Oct 31, 2019
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Neutropenia: Treatment, Procedure, Cost and Side Effects

What is Neutropenia? How is the treatment done? Are there any side effects? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent?

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.

Popular Questions & Answers

I am 42 years old male. I have neutropenia from last 3 months. What should i do? Please advise.

MD - Pathology
General Physician, Amritsar
See a medical specialist. You need to be investigated for the possible underlying cause. Certain medicines also cause this, check with your medicines if you are taking any. Treatment of cause will treat neutrpenia. Till then avoid going to crowded...

Hi, I am a thalassemia carrier patient with alpha trait, and my girlfriend also having the same thalassemia trait issue. Moreover recently I am diagnosed with Neutropenia. My question is should I continue with my gf? Does it cause any problem, to our future generation or to my gf while conceiving?

Hematologist, Gurgaon
Ok love has no boundaries Continue with your girl friend when planning for baby please chekc the baby between 9 to 12 weeks of pregnancy and if baby is found to be major then abort otherwise continue with pregnancy and live your life Why did you d...

HI, I have been having extreme pain in my fingers and hands. They are very red, swollen a little bit itchy. When I wake up in the morning they are numb with no feeling. Like I have very bad circulation. I also have a red burn like rash on my shoulder with pain like I had a muscle pull. I don’t know if the two are related or not. I am very bad at going to the doctors. But I just looked at my last blood test which was in january 2019. I only had a blood test because I just took a job. So i’m noticing my rbcs for my urine analysis were 11-30. When the result should be 0-2. I’m not into the doctor in years last time was june 2017 and I did have a blood test and he did call me back because there were abnormal things and I did not follow up. I’m wondering could this be arthritis then I was reading about lupus and kidney failure. I did have a immune disorder called cyclic neutropenia. I got that when I was about 13 years old and I was on prednisone for about 13 years a lot of prednisone. Then I went on neupogen shots about twice a week to bring up my white blood cells. Then about six years ago I stopped taking neupogen because my wbc seemed to be ok. Now I don’t know if this is another immune system disorder. But the pain in my hand since it is cold out have been very bad and i’m nervous. They’re starting to look funny and a bone is starting to pop out in the palm area of one finger. I started the pain about august and then it started to go away after a few weeks and then I would come back and then go away but right now it’s very bad. Any thoughts?

MBBS, MD - Physical Medicine & Rehabilitation
Orthopedist, Mumbai
Even though cyclic neutropenia is a rare disease, it is genetic. Individuals with cyclic neutropenia should be genetically tested for mutations in the elane gene. Your present symptoms could be related to your basic condition only since the treatm...

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