Neutropenia

Neutrophils are a subgroup of leucocytes, the white blood cells. The white blood cell count (WBC) is the number of white blood cells in a volume of blood. The normal range for the WBC varies slightly among laboratories but is generally between 4,300 and 10,800 cells per microliter or cubic millimeter (cmm). The percentage of the different types of white blood cells in the WBC is called the WBC differential.

The absolute neutrophil count (ANC) is determined by the product of the white blood cell count (WBC) and the fraction of neutrophils among the white blood cells as determined by the WBC differential analysis. For example, if the WBC is 10,000 per microliter and 70% are neutrophils, the ANC would be 7,000 per microliter.

Patients with acute infectious episodes, suggested by fever or any other symptom need to be evaluated urgently. Some can be treated with oral antibiotics, while patients with severe neutropenia or those who are suspected to have severe infections should be hospitalized and treated with intravenous antibiotics until improvement. In case of recurrent infections or severe chronic stomatitis with profound neutropenia, long-term granulocyte colony stimulating factor (G-CSF) therapy may be considered.