Low White Blood Cell Count Symptoms, Tests & Prevention
Why is there more than one test for white blood cell counts?
A standard blood count calculates the number of white blood cells (WBCs) per microliter of blood. This is also called the total leukocyte count, or TLC. A healthy person has between 4,500 and 11,000 of them. A second test, called a differential count, or "diff," breaks down the count into five different types of white blood cells: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Healthy blood is made up of approximately 60 percent neutrophils, 30 percent lymphocytes, 5 percent monocytes, 4 percent eosinophils, and 1 percent basophils. Knowing which types of white blood cells have been most affected helps the doctor evaluate a patient's risk of becoming immune suppressed.
One way doctors measure this risk is with a test called the absolute neutrophil count, or ANC, which calculates the percent of neutrophils in the total white blood count. The risk of infection increases as the ANC falls; if someone's ANC falls below 1,000, he has a moderate risk of infection, while an ANC under 500 carries a high risk of infection.
Is there a way to prevent white blood cell count from dropping?
Yes, if the doctor determines you or the person you're caring for is at risk of losing too many white blood cells, she can prescribe a white blood cell booster, more formally known as a colony stimulating factor, or CSF. These popular drugs are called filgrastim and pegfilgrastim -- or Neupogen and Neulasta, their brand names. It's common to begin taking the drugs at the start of chemotherapy, in the hope that they'll boost white cell production and strengthen the body's natural defense system. The doctor can also prescribe them later to try to bring the white count up if it doesn't rise fast enough on its own.
What symptoms should I watch for related to low white blood cell count?
When white count is low, you need to be on the alert for fever, which is usually the first sign that the body is fighting off an infection. Someone with low white cell blood count has less resistance to colds and flu, so those are definite threats, but other kinds of infections can appear as well. Gastrointestinal infections may show up as cramping or diarrhea, while a bladder or urinary tract infection makes it hurt to urinate. Even a tiny cut or scratch can become infected, so watch for redness, swelling, pus, or tenderness around any wound. Also keep an eye out for sinus infections, usually evidenced by a stuffy nose or headache; rectal bleeding; or signs of lung infection such as coughing up fluid.