Neutropenia

What is Neutropenia?

Neutrophils are blood cells that are produced in the marrow, or core of the bones. The blood normally contains 2500 to 9000 neutrophils/mm(3). When the number of neutrophils in the blood falls below 1000 cells/mm(3), the condition is [called] NEUTROPENIA.

Neutrophils are very important because they fight infection. When bacteria invade the body, a chemical signal is sent out and the neutrophils, like fire fighters responding to a blaze, rush to the site of infection. The bone marrow also responds by speeding up its production of neutrophils to replace those involved in fighting the infection. If, however, production of new neutrophils is suppressed or slowed down, a shortage may develop, and any infection can overwhelm the few neutrophils available. Therefore, a person with only a few neutrophils is at particular risk for developing a serious infection.

Chemical agents, physical factors, and certain infections can affect hte bone marrow's production of cells. Because anticancer medications destroy normal cells as well as malignant cells, they can suppress the bone marrow's production of neutrophils. Patients receiving treatment that may result in neutropenia are given blood tests routinely to determine their neutrophil counts. If neutropenia does develop, patients must take extreme care to minimize the risk of infection.

What can I do to reduce my risk of infection if I have neutropenia?

• Not eating raw fruits and vegetables, because they can carry bacteria and fungi.
• Avoiding fresh plants and flowers because they can carry bacteria and fungi on them or in the dirt.
• Avoid stagnant water (as in denture cups, humidifiers, and open bottles of liquids).
• Avoid contact with people with infections/colds.
• Good hand washing by patient and all people around them.
• Good oral hygiene (no commercial mouthwashes, soft tooth brush after all meals and at bedtime, and salt water or baking soda mouth rinses).
• Avoid being out in crowds, e.g., malls, movie theaters, church, etc.
• Notify your Oncologist prior to any invasive procedure (dental work, dental cleaning, diagnostic tests, etc.). The oncology nurse can offer further instructions to help patients with neutropenia to minimize the risk of infection.

Because of your lowered immune system, you may not show the normal signs and symptoms of an infection should you get an infection. It is very important that you call your physician anytime you have any actual or potential sign of an infection. An infection in a neutropenic patient is considered an emergency, (Daytime or nighttime).

What should I call my physician about immediately?

• Temperature greater than 100.4 degrees
• Shaking chills
• Cough or congestion
• Any redness or drainage from any IV site (port, catheter, etc.) or any other area

Call your Physician as soon as possible during office hours or during the daytime (but within 24 hours of developing these):

• Frequent or painful urination
• Rectal pain
• Oral pain/discomfort
• Any other signs of infection