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Immunity and infection prevention

What is neutropenia

The main article (“What is neutropenia?”) explains the blood count. This topic focuses on neutropenia itself: when it happens, its grades and what changes in daily life.

Last updated: ~1 min read
Patrolling neutrophils with gaps.
Figure 1.The neutrophil guards have thinned out.

01Short answer

Neutropenia is a shortage of neutrophils in the blood. Neutrophils are the first defenders against bacteria and fungi. In leukaemia, neutropenia comes both from the disease itself (the marrow is filled with blasts) and from chemotherapy. After chemotherapy, neutrophils usually fall over several days, reach their lowest point (the nadir) and then recover. Neutropenia can be mild, moderate or severe; when it is severe, even a small infection can quickly become serious. Neutropenia itself is usually not felt: there are no symptoms, so it is found only by a blood test.

02Simple explanation

Neutropenia: too few neutrophils.

Not felt: seen only in a test.

Fever: an urgent signal.

03Scientific explanation

Nadir: the lowest neutrophil level; its timing depends on the treatment, and your team plans for it.

Grades: mild, moderate, severe; in severe neutropenia the infection risk rises sharply (“How to read neutrophils and ANC”).

04What happens in the body?

Sparse guards

Neutrophils patrol the blood; in neutropenia gaps open up between the guards.

The valley

After chemotherapy, neutrophils dip like a valley and then rise again.

A soft valley-shaped line.
Figure 2.Neutrophils fall and rise like a valley.

A protective period

The days at the bottom are a time for extra care.

A calendar with a shield.
Figure 3.The nadir days are a protective period.

05The course of neutropenia

Four steps.

Normal — Enough guards.1NormalEnough guards.
Falling — Drops after treatment.2FallingDrops after treatment.
Nadir — The lowest point.3NadirThe lowest point.
Recovery — The guards return.4RecoveryThe guards return.

06Grades of neutropenia

GradeWhat it means
MildRisk slightly raised
ModerateRisk clearly raised
SevereHigh risk; fever is an emergency
Prolonged severeFungal risk also rises

07Key terms

Neutropenia
A shortage of neutrophils.
Nadir
The lowest level.
Febrile neutropenia
Neutropenia with fever.
ANC
Absolute neutrophil count.
Growth factor
A medicine that can speed neutrophil recovery.

08Key points

  • Neutropenia means too few neutrophils.
  • It is not felt.
  • After chemotherapy it falls and rises like a valley.
  • Severe neutropenia carries high risk.
  • Fever is an emergency.
  • Your team knows when the nadir is.

09Frequently asked questions

How do I know I have neutropenia?

Only from a blood test (“How to read neutrophils and ANC”).

Can I stay at home?

Often yes, but follow the advice and seek help at once if you get a fever.

Can neutrophils be raised?

Sometimes a doctor prescribes a growth factor (“Supporting blood count recovery”); food cannot “raise” them.

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 do I know I have neutropenia?

  2. Can I stay at home?

  3. Can neutrophils be raised?

My questions

12Sources

  1. National Cancer Institute (NCI). Definition: neutropenia
  2. MedlinePlus (U.S. National Library of Medicine). Blood Differential
  3. American Cancer Society. Infections in People with Cancer
  4. National Cancer Institute (NCI). Infection and Neutropenia during Cancer Treatment
  5. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: splenomegaly
  6. MedlinePlus (U.S. National Library of Medicine). Spleen Diseases
  7. MedlinePlus (U.S. National Library of Medicine). Swollen lymph nodes
  8. NHS (UK). Swollen glands
  9. American Cancer Society. Immunotherapy for Acute Lymphocytic Leukemia
  10. Journal of Clinical Oncology (ASCO and IDSA), 2018. Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression: ASCO and IDSA Clinical Practice Guideline Update
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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