Next to cancer itself, defending an immune system compromised by chemotherapeutic agents is one of the most significant battles a cancer patient faces.
White Blood Cell Basics:
Leukocyte is the term that covers all six types of white blood cells:
The life span of a leukocyte is approximately 1 to 3 days. White cells are more sensitive to chemo than red blood cells and platelets, possibly due to their rapid turnover.
Chemotherapy destroys not only cancer cells but red cells, white blood cells and platelets. When the level of leukocytes drops the risk for infection increases. Chemotherapy may be delayed and/or a lower dosage may have to be given.
One out of every three chemo patients will develop neutropenia.
What is neutropenia?
Neutropenia is measured by the Absolute Neutropenia Count or ANC, which is measured in cells per microliter of blood.
Mild Neutropenia: between 2,000 and 1,000
Moderate Neutropenia: between 1,000 and 500
Severe Neutropenia: less than 500
While each patient is evaluated on an individual basis, often chemo therapy will not be stopped until a patient reaches severe levels of neutropenia.
The lowest point that a patient’s blood count drops after chemotherapy is called the nadir. The nadir usually occurs about seven to ten days after treatment. At this point a patient is the most susceptible to infection.
Other Signs and Symptoms of Neutropenia:
- sore throat
- mouth sores
- signs of infection
- burning with urination
- shortness of breath
If you are neutropenic your health care team will do everything possible to protect your compromised immune system including prescribing antibiotics, and granulocyte colony stimulating factor.
What is G-CSF?
White blood cells are not given via transfusion since these cells only live for twenty-four to forty-eight hours. The risk of reaction is highly likely.
Instead G-CSF is given. This injectable agent increases the production of neutrophils.
Types of G-CSF:
- Filgrastim (Neupogen): daily injections
- Lenograstim (Granocyte) daily injections
- Pegylated filgrastim (Neulasta) long lasting
A summary of G-CSF by the National Cancer Institute:
“Granulocyte colony-stimulating factor (G-CSF) is a hormone produced by the body that stimulates the bone marrow to produce more white blood cells. G-CSF is also made as a drug. Studies have found that G-CSF injections reduce the severity and duration of neutropenia in patients with some types of cancer. It’s been unclear, however, whether G-CSF is helpful only in certain circumstances or whether many patients with cancer might benefit from it. Treatment with a G-CSF drug is a form of biological therapy.”
- Good hand washing
- Keep the skin intact
- Avoid others who have infections
The American Cancer Society provides an excellent down loadable pdf document on cancer and neutropenia. Read it before you begin treatment.