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When counts start to rise: step by step

The recovery of neutrophils, platelets and hemoglobin is an important and happy stage of treatment. But the rules should not all be dropped at once: recovery is gradual, and the next cycle may lower the counts again.

Last updated: ~1 min read
The sun rising over a calm sea
Figure 1.Counts are rising — a new day

01Short answer

Ask your team which counts have recovered, which rules can now be relaxed and what stays the same. Hand hygiene and checking your temperature always stay. Add new activities one at a time: first a short walk, then a shop at quiet times, and so on. Plan visitors, work, study and travel with your team. After a transplant, immunity takes months to recover, and there are special rules. Tiredness may last longer than low counts; that is normal. For a fever, bleeding or any new symptom, still call at once.

02Simple explanation

Ask what changes.

Hands: always.

Add things one at a time.

Fever: call.

03Scientific explanation

NCI: blood counts usually recover after chemotherapy, but later cycles can lower them again; your team adjusts the rules.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Recovery

The bone marrow starts making new cells again.

Cycles

Counts can fall and rise after each cycle.

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
RecoveryThe bone marrow starts making new cells again.
CyclesCounts can fall and rise after each cycle.
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Count recovery
The return of blood counts to normal levels.
Engraftment
When new cells take hold after a transplant.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • Ask.
  • Go gradually.
  • Stay alert.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

Do I still need a mask?

Your team decides; it depends on your counts and stage.

I am still tired.

Tiredness lasts longer; tell your team.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

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. Do I still need a mask?

  2. I am still tired.

  3. What should I watch every day?

My questions

12Sources

  1. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  2. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  3. National Cancer Institute. Anemia and Cancer Treatment
  4. World Health Organization. World Hand Hygiene Day
  5. National Cancer Institute (NCI). Chemotherapy to Treat Cancer
  6. National Cancer Institute (NCI). Female Fertility and Cancer Treatment
  7. National Cancer Institute (NCI). Male Fertility and Cancer Treatment
  8. National Cancer Institute (NCI). Hair Loss (Alopecia) and Cancer Treatment
  9. National Cancer Institute (NCI). Feelings and Cancer
  10. National Cancer Institute (NCI). Mouth and Throat Problems during Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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