Leukaemia is a type of cancer which begins in bone-marrow cells and then spreads to affect other cells in the body including neutrophils, a type of white blood cell which is responsible for attacking blood-borne bacteria. Leukaemia and leukaemia treatments (such as chemotherapy) can cause low neutrophil counts, a condition known as neutropenia. Neutropenia does not cause symptoms but can lead to complications which vary in accordance with the severity of the condition.
Low Neutrophil Levels
According to National Institutes of Health, normal neutrophil levels should be between 2500 and 6000 neutrophils per mm3 (cubic millimetre) of blood. The National Neutropenia Network classifies mild neutropenia as being characterised by neutrophil levels between 1000 per mm3 and 1500 per mm3. Moderate neutropenia is characterised by neutrophil levels between 500 per mm3 and 999 per mm3. Severe neutropenia is characterised by neutrophil levels which are lower than 500 per mm3.
According to The National Neutropenia Network, the risk of infection increases as neutrophil levels decrease. Patients with low neutrophil levels for three or more days are at a greater risk of developing an infection such as a fungal infection, ear infection or tonsillitis. Urinary-tract infections and infections of the rectum, colon and reproductive tract are also common. Signs of possible infection include burning while urinating, increased urinary frequency, blood in urine, diarrhoea, fever, sore throat, nasal congestion, a feeling of breathlessness, increased perspiration, stomach pain, vaginal discharge or itching, or redness or swelling around an injury. If patients have a fever above 38.6 degrees Celsius or any new pain, they should consult a doctor as soon as possible since even minor infections can intensify quickly.
Mouth Sores or Gum Disease
The University of California San Francisco Children’s Hospital states that children with low neutrophil levels commonly experience painful ulcers or sores in the mouth, gum infections, or periodontal disease. This also applies to adults with the condition. According to the National Institute of Health, patients with low neutrophil levels should use a soft toothbrush, rinse gums and teeth with water after meals and before bed, and protect the lips from chapping.
According to the National Institutes of Health, patients with low neutrophil levels can prevent infections by taking precautions such as avoiding contact with sick people, practicing frequent hand washing and avoiding having any dental work completed until neutrophil levels are raised. Additionally, patients with neutropenia should monitor body temperature once daily, bathe daily and check for signs of infection.
- National Neutropenia Network: What is Neutropenia
- University of San Francisco Children's Hospital: Neutropenia Signs and Symptoms
- Oncologist-approved cancer information from the American Society of Clinical Oncology: Neutropenia
- Clinical Center/National Institutes of Health: Understanding Your Complete Blood Count