Neutropenia is an abnormally low concentration of neutrophils (a type of white blood cell) in the blood
What is neutropenia?
Neutropenia means there are not enough neutrophils in the blood. Neutrophils are white blood cells that are important for fighting infections. The body produces about 100 billion of these cells each day.
If someone has neutropenia they are at more risk of developing infections.
Neutropenia following chemotherapy is caused by the healthy cells being targeted as well as the lymphoma cells. This can happen with many types of chemotherapy and if there is a low number of neutrophils the risk of infections is higher.
Infections can start anywhere in the body and the most common areas affected are the airways, digestive system, and bladder. If the neutrophils are low the normal signs of infections may be absent. A fever may be present but swelling, redness and warmth may be absent.
Patients are most at risk of developing neutropenia 7-12 days after chemotherapy. Always contact the health care team if there are signs of infection.
Treatment and management
- Prophylactic (preventative) antibiotics such as trimethoprim
- Prophylactic (preventative) antiviral medications such as Acyclovir
- Prophylactic (preventative) antifungal medications such as fluconazole
- Growth factor hormones- most used is G-CSF (granulocyte-colony stimulating factor) triggers bone marrow to make more white blood cells. Examples are Neupogen and Neulasta.
- Get enough sleep and rest
- Keep physically active
- Reduce stress where possible
- Stay away from sick family and friends
- Avoid crowded places
- Practice social distancing where possible
- Wash hands regularly with soap and water
- Take care of the skin and avoid scratches and abrasions
- Be careful when doing activities that can lead to injury or infection. This includes things such as mowing and gardening
- Clean cuts and abrasions immediately. Use antiseptic and keep wounds clean and dry
- Be careful when handling animal waste. Do not change cat litter.
- Careful food handling is especially important to prevent food-borne infections.
- Always wash hands thoroughly before eating
- Always wash hands before and after preparing food
- Always use separate chopping boards for meat, poultry, and fish
- Keep raw meat, seafood, and eggs away from ready to eat foods. Avoid raw and undercooked meat or poultry. Do not eat foods with raw egg in it. Do not eat smoked meats or fish
- Discard sponges and wash dish towels regularly
- Cook food thoroughly at proper temperatures
- Wrap and refrigerate leftovers or freeze within one hour of preparation to limit growth of bacteria
- Make sure honey and dairy are pasteurised. Avoid mould ripened cheeses, blue cheeses and soft cheeses
- Pay attention to expiry dates of food
- Do not buy or use foods in cans that are dented or damaged
- Avoid food from deli-counters
If any of the below symptoms are present after chemotherapy, please contact the nurse or doctor:
- Fever above 38 degrees Celsius
- Feeling unwell
- Chills and shivering
- Sore mouth or gums
- Pain or swelling in gums
- Sore throat
- Redness, swelling or sores on the skin
- Cough or shortness of breath with fever
- Fast heart rate or breathing
- Diarrhoea, nausea, and vomiting
- Feeling cold and clammy
- Passing less urine than normal