Topic Overview

What is neutropenia?

Neutropenia (say "noo-truh-PEE-nee-uh") means that your blood has too few white blood cells called neutrophils. White blood cells are an important part of your body's immune system. Neutrophils help protect your body from infection by killing bacteria.

You can get infections easily when your white blood cell count is low. That's because your body can't fight off germs as well as it should. Even a mild infection can quickly become serious. So it's important to take extra measures to avoid infections and to be alert for signs of infection. Your doctor can tell you how long to keep up these precautions.

What causes neutropenia?

Neutropenia is often caused by cancer treatments such as chemotherapy and radiation. These treatments destroy cancer cells, but they can also decrease your body's ability to make white blood cells.

Other causes include:

• Immune system conditions such as HIV or lupus.
• Cancers such as leukemia and myelodysplastic syndromes. These cancers cause the body to make abnormal blood cells.
• Some types of infection.
• Low levels of vitamin B12 or folic acid.
• An enlarged spleen.

How can you prevent infections?

Take care of your skin

• Wash your hands often. You can use soap and water or an alcohol-based hand sanitizer. Cleaning your hands is especially important before you eat; after you go to the washroom; after you touch an animal; and after you sneeze, cough, or blow your nose.
• Shower or bathe daily. Pat your skin dry, and apply lotion to keep skin from drying and cracking.
• Use a soft toothbrush, and brush gently. Do not floss. Your doctor may prescribe a non-alcohol mouthwash to help prevent mouth sores.
• Be careful not to cut yourself. Use an electric razor. Do not trim your cuticles. Be extra careful with knives, needles, and scissors.
• If you get a cut or wound, clean it right away with warm water and soap. Cover it with a clean bandage.

Protect yourself from infection

• Avoid crowds and people who are sick. You may also need to avoid people who have had certain vaccinations.
• Wear a face mask when you have to be in public or go to appointments.
• Wear gloves and a mask when you garden or when you handle pet wastes.
• Talk to your doctor before you get any vaccination, including the flu vaccine.

Be careful with foods

Your doctor can tell you the best ways to handle and prepare foods to help avoid infections. You may also need to avoid certain foods. For example, your doctor may tell you to:

• Eat only well-done meat, fish, and eggs. Germs that live inside these foods are not always killed unless the food is fully cooked.
• Scrub raw fruits and vegetables before you eat them. Germs on fresh fruits and vegetables are not always easy to wash off.
• Avoid foods that can't be washed well, such as raspberries.

What are the signs of infection?

Fever is a common sign of infection. So your doctor may ask you to check your temperature every day and keep a written record of your readings.

Call your doctor or nurse advice line right away if you think you have an infection. Any infection can become very serious for people with neutropenia, so it is very important to seek treatment right away.

Common signs of infection include:

• Fever of 38 C (100.4 F) or higher (this may be the only symptom).
• Chills or sweating.
• Cough or shortness of breath.
• Nausea or vomiting.
• Redness, pain, swelling, or warmth around a sore or IV site.

Other possible signs include a sore throat or mouth sores, vaginal drainage or itching, diarrhea, pain when you urinate, or a need to urinate often.

How is it treated?

If your white blood cell count is very low, your doctor may give you medicine to help protect you, such as:

• Antibiotics to help prevent infection.
• Medicine to help your body make white blood cells.

If you get an infection or a fever, you may need to be treated in the hospital. To fight the infection, your doctor may give you antibiotics through a vein (intravenous, or IV). This gets the medicine into your bloodstream quickly. Some people may be allowed to take antibiotics by mouth.