Understanding Low White Blood Cell Counts

How a low white blood cell count affects health and how the doctor might treat it
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White blood cells are the body's best defensive weapons in the fight against germs and disease, so when white blood cell counts drop as a result of chemotherapy, radiation treatment, or certain types of cancer, it puts the patient in a vulnerable position. Without adequate protection from these disease-fighting cells, viruses and bacteria suddenly become much more serious threats.

Why does chemotherapy make white blood cell counts drop?

Think of chemotherapy as a smart bomb: It only targets certain types of cells, particularly those that grow and divide rapidly. That means it targets tumor cells, but it also means that white blood cells, which are produced in the bone marrow and have a rapid turnover rate, can be damaged as well. White blood cell counts, sometimes called leukocyte counts, drop with most chemo drugs. Neutrophils, which are a specific type of white blood cell, are the most potent disease fighters. The doctor may refer to a low white blood cell count as neutropenia, since a shortage of neutrophils is often what the doctor is most concerned about.

What are the risks of having a low white blood cell count?

White blood cells, or leukocytes, help fight bacteria and viruses. They're like the armed guards at the gates of the body, driving back the invaders. When there are too few white blood cells, a patient's immune system is compromised, putting him or her at increased risk of all types of infection : bacterial, viral, and fungal.

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.

Low White Blood Cell Count Treatment & Prognosis

How long will it take for low white blood cell count to come back up?

It's common for white blood cell count to begin to drop a few days after each chemo treatment and will be at its lowest level during weeks two and three following chemo. Then, as the bone marrow gradually begins to recover and produce new white blood cells, the count will rise. If this doesn't happen, or if you see signs of infection, the doctor may prescribe another CSF to try to boost white blood cell production.

If someone's white blood cell count is low, but he or she is otherwise healthy, is there reason to worry?

That's the mystery of it: Almost every cancer patient experiences a drop in white count following chemotherapy (also after some types of radiation), but only a small percentage of patients experience serious infection. Whether someone is going to get sick depends on a host of factors, such as age, another condition that might affect the immune system, other medications, and his or her general state of health before the chemo. The doctor will likely say not to worry about a low white blood cell count unless the absolute neutrophil count, or ANC, drops into the high-risk category. And even then, the usual strategy is to simply become more vigilant in watching for signs of infection.


3 months ago, said...

My husband has now had 3 bouts of pneumonia and his white blood count is now .4. What can we do to improve his health and increase his white cells. And what time frame.


3 months ago, said...

My brother has low white and red cells and his doctor dose not know why.


5 months ago, said...

My white blood cell count is 11.7 .I am self injecting to boost my white cells. even thou they are now above normal !!


5 months ago, said...

My white blood cell count has been ranging from 4 to 2.9 varying up and down monthly. I am on tegretol and abilify for bipolar. Should I be concerned.


5 months ago, said...

Chemotherapy poisons the body,i know because i almost died from this barbaric treatment..Luckily i am still alive almost twenty years later,had osteo sarcoma in right shoulder fore quarter amputation,if i had known then what i know now i would never have let those witch doctors administer those toxins.The only reason i am still alive i stayed away from allopathic doctors and their poisons,but unfortunately as i got older because of the toxins i was given my white blood cell count has declined rapidly i am now 63,and i have to fight to stay reasonably healthy,My bones and joints hurt like hell almost every day i only eat organic food and no pharmaceutical poisons enter my body chemotherapy is a death sentence sooner or later so beware.Take care H.H


6 months ago, said...

Is 2.1'low white blood count for a relatively healthy person a need for concern?


7 months ago, said...

My white cells have been ranging around 3.5 to 3.9 for around a year but usley i get a little sick for a day to three days and then I fine now a dr wants me to check into it to see if somethings going on because my legs have been bothering me for around 3 years. I have been blaming it on the medal I use to take for pain. What do you think


9 months ago, said...

Should I be concern about my lowwhite blood cells that was very low last month when I went to the Doctor ?


12 months ago, said...

My white count is low and contuies to drop. Have had abone marrow test and no sign of cancer but I have no energy and am out of breath a lot . Is there any food I can eat that will build count up?


over 1 year ago, said...

my sister has shortage of white blood cell. she tested in hospital. it is two months ago she after she got this disease. So, how can I treat her please? what kind of food shall I feed her? She is in siriouse problem she feel tired ...


over 1 year ago, said...

I am a diabetic ,,had a medical donme and discovered my white bllod count was down to 4 ,should I worrie


over 1 year ago, said...

My white cells are down to 2100.00 ,,I realize that's why I'm tired and sick in my tummy


almost 2 years ago, said...

My son has pneumonia 25yrs old white cell count drop but drs say that the white cell count is going bk up again so does this mean he will be ok a worried mom


about 2 years ago, said...

Daughter has low wbc..lower back and extremity pain..has had cancer surgery for colorectal cancer a year ago and been in pain since with this low wbc..received chemo and radiation..nothing seems to help..extremely tired..some bleeding from stomach and bowel blockage once in which she was hospitalized..doctors seem to be at loss..need help


over 2 years ago, said...

My father has hepatitis c and he is under injections treatment.He has low tlc and low paletelets. Last report tlc:2,000/cmm paletelets 123,000/cmm So what we can do for him to cure?


over 2 years ago, said...

What food they fear the lack of them white blood cells?


over 2 years ago, said...

okaaaaaay. nice article


over 2 years ago, said...

I am a 37 year old breast cancer patient undergoing radiations after sugery and six cycles of chemo. My TLC is declining to 3200. I am diagnosed with her2 neu positive. They are saying for hercrptin


almost 3 years ago, said...

Hi: My WBC count is 3.1 down of 0.6 from 2012. My Monocyte is high @ 12 plus. I am very worried. Can taking pain killer (Celebrex & lyrica & vomono, declofenac, etc) and Gabapentin cause the falling? I am going to a winter country for vacation n like to know if I can go for flu vaccination n will that affect my WBC count to drop further? Very Worried. Thanks!


almost 3 years ago, said...

Hello, I am very concerned for my mother who has very low white blood cell count for about a year. My mother has always been very active,happy & full of life, now shes very tired & always want to be in bed resting, she can start getting ready to go out & then changes her mind & sits or lays back down. No doctor has been able to help her & quite frankly I am irate & with tons of fear for her well being. My father passed away 3 yrs ago & seeing my mother this way is heart breaking. What can be done to help her ?? what can she eat or what medicine can help her ? I need her , shes my best friend & best mom ever.


almost 3 years ago, said...

i have wbc increase and decrease problem so how can i tc my self and how time i can live what symptom can come in my body .what things i can eat or can't eat


over 3 years ago, said...

I don't have cancer, I am not on chemo, theonly Rx I take is serevent,.. but I have had a low white count for 6 years.. I have a shoulder replacement coming up soon, how can i increase my white count....


over 3 years ago, said...

my husband has just finished six rounds of chemotherapy which have each been four and a half days in the hospital. He left the hospital on Sunday, had a shot of neuperin on Mon and Tues, and it is now Thursday. I, his wife and caretaker, am suddenly running a temperature of 100.5 F. He does not yet have a temperature. What should I do?


over 3 years ago, said...

I just found out that my white blood cells are very low witout any reasons given,can u tell me whats wrong with me?On top of all that I have bone fragments in my knew and I have to go and have surgery I am so scared of all whats happening to me I don't know what to do,its just a combination of illness.I also have migrains and heart palpitations every 2 sec is there a diagnoses for that problem?


over 3 years ago, said...

My son has been sick allot his first year of school basically from september to february every time he gets better he gets sick again about a week later. At what point should the Dr check his white blood cell count?