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Questions and answers

What is ANC?

The ANC (absolute neutrophil count) is the key number for infection risk. You will hear it often during treatment.

Last updated: ~1 min read
Neutrophils, the guards of the blood
Figure 1.Neutrophils, the guards of the blood

01Short answer

ANC is the absolute number of neutrophils in the blood. Neutrophils are the first line of defence against bacteria and fungi. ANC is calculated by multiplying the total white cell count by the share of neutrophils. When ANC is low (neutropenia), infection risk rises; when it is very low, even a mild infection can become serious quickly. At such times a fever is an emergency and you should call your team straight away.

02Simple explanation

Neutrophils are the body’s “first response team”.

The lower the ANC, the more the protection rules matter.

03Scientific explanation

ANC below 1500/µL is usually called neutropenia and below 500/µL severe neutropenia; thresholds can differ slightly between centres.

In neutropenia signs of inflammation (redness, pus) may be faint, so a fever is sometimes the only sign.

04What happens in the body?

How it is calculated

The total white count is multiplied by the share of neutrophils (segmented and band forms together). Often the lab reports ANC directly.

What a low ANC means

After chemotherapy ANC can stay low for days or weeks. During that time hand hygiene, food safety and avoiding crowds and sick people matter.

Low ANC: few guards — What is ANC?
Figure 2.Low ANC: few guards — What is ANC?

When to call

If you have a fever, chills, breathlessness, sudden weakness or redness at a line site, call your team without waiting.

Recovery: the guards return
Figure 3.Recovery: the guards return

05How ANC is found

Four simple steps.

White cells counted — The total white cell count.1White cells countedThe total white cell count.
Neutrophil share — The differential gives the neutrophil percentage.2Neutrophil shareThe differential gives the neutrophil percentage.
ANC calculated — The two numbers are multiplied.3ANC calculatedThe two numbers are multiplied.
If low, protect yourself — Extra care with the rules.4If low, protect yourselfExtra care with the rules.
Understanding riskANC shows infection risk.
Quick actionCall at once with a fever.

06Key points at a glance

TopicIn brief
How it is calculatedThe total white count is multiplied by the share of neutrophils (segmented and band forms together). Often the lab reports ANC directly.
What a low ANC meansAfter chemotherapy ANC can stay low for days or weeks. During that time hand hygiene, food safety and avoiding crowds and sick people matter.
When to callIf you have a fever, chills, breathlessness, sudden weakness or redness at a line site, call your team without waiting.

07Key terms

Neutrophil
A white blood cell that fights bacteria.
ANC
Absolute neutrophil count.
Febrile neutropenia
A fever with low ANC, an emergency.

08Key points

  • ANC is the neutrophil count.
  • A low ANC raises infection risk.
  • A fever is an emergency.
  • Protection rules matter most when ANC is low.

09Frequently asked questions

How can I raise my ANC?

No special food or herb does this; sometimes the doctor prescribes growth factors.

Can I go out with a low ANC?

Sometimes, but avoid crowds; ask your team’s rules.

When will ANC recover?

It depends on the regimen; your doctor will tell you the expected time.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. How can I raise my ANC?

  2. Can I go out with a low ANC?

  3. When will ANC recover?

My questions

12Sources

  1. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: absolute neutrophil count
  2. National Cancer Institute (NCI). Infection and Neutropenia during Cancer Treatment
  3. MedlinePlus (U.S. National Library of Medicine). Complete Blood Count (CBC)
  4. NHS. High temperature (fever) in adults
  5. NHS. Stem cell and bone marrow transplants
  6. NHS. How to wash your hands
  7. MedlinePlus (U.S. National Library of Medicine). Peripherally inserted central catheter - dressing change
  8. Cancer Research UK. Coping emotionally with cancer
  9. National Cancer Institute (NCI). When Someone You Love Is Being Treated for Cancer (booklet)
  10. MedlinePlus (U.S. National Library of Medicine). Histocompatibility antigen test
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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