Can You Get Chemo With a Low White Blood Cell Count?

A fellow caregiver asked...

What options are there is your white blood count never gets high enough to take chemothaerapy?

Expert Answer

Andrew Putnam, M.D. is a Palliative Care physician at Smilow Cancer Center at Yale New Haven Hospital and Yale University.

It is important to remember that chemotherapy's main goal is to kill cancer cells, but chemo drugs also kill off some healthy cells also (hair follicles, the cells lining the intestines, etc.)  In order to be eligible for chemotherapy, you need to be healthy enough to survive the drug.  If a patient is too weak or has some other severe problem like low white blood cells, the risk is that the chemotherapy could hasten the person's death. 

This is why when your white count is too low, for your safety the oncologist will refuse to give chemotherapy.  So it's important to realize that the refusal is for the patient's safety even if the patient is very sick.

I'm assuming your doctor has already tried Neulasta, the cell growth factor that is used to help boost white counts. If Neulasta is not bringing your white count high enough, your choices include:

1) Continue to follow up with the oncologist in case the white blood cell count does finally get high enough
2) See if radiation would be helpful for some localized aspect of the cancer
3) Live life the best one can to get the maximum use or enjoyment out of life each day
4) If pain or other symptoms are causing suffering, consider a seeing a palliative care doctor or hospice intervention in the home.