What is blood leukopenia?
Leukopenia (low white blood cell count or white blood cell count) means that too few white blood cells circulate in the blood. The presence of low white blood cell counts for a long time increases the risk of infections and can be caused by a number of different diseases and conditions.
Neutrophils are the most common type of white blood cell involved in the destruction of pathogens; thus, leukopenia is often associated with an increased level of bacterial and fungal infections (Merck 2006, 2012a).
To determine the number of leukocytes, first of all, a complete blood count is done, which, in addition to leukopenia, can show a change in the quantitative composition of other blood cells (red blood cells, platelets). Additionally, if you know what blood leukopenia is and how to cope with it, you can avoid serious complications.
Video: What is Leukopenia?
What does leukopenia mean in a blood test?
White blood cells fight infection. The normal number of leukocytes ranges from 5,000 to 10,000 cells. The number of leukocytes below 1000 cells increases the risk of infection.
White blood cells are divided into several types, each of which carry out the corresponding functions:
- Neutrophils help fight bacterial infections.
- Lymphocytes produce antibodies to fight infections.
- Monocytes help fight infection by killing and eliminating bacteria.
- Basophils and eosinophils are involved in an allergic reaction.
The term “AKN”, which means “Absolute neutrophil count”, means the total neutrophil count in the total leukocyte count.Often called ACN indicator "fight against infection." The lower the AKN falls, the higher the risk of infection. When ACN is defined below 500, the risk of infection is extremely high.
|ANC value||Risk of infection|
|Below 500||The greatest|
|500 to 1000||Moderate|
|More than 1000||Low|
In most results of blood tests, you can see that ACN is already calculated. If this indicator is not available, you can ask the laboratory to additionally report the ACN. To independently determine the AKN, you can use the following formula:
AKN = (% stab +% segmented) x WBC, where WBC is the number of leukocytes.
For example, in the analysis it is indicated that WBC = 1000%, segment-core = 20%, band-core = 1%.
Calculation by the formula: AKN = (20% + 1%) x 1000, AKN = (0.21 x 1000), AKN = 210, which means a high risk of infection.
What is blood leukopenia in adults?
It was stated above that there are certain types of white blood cells, each of which has a different ability to fight diseases. In accordance with the lack of a particular type of white blood cells, a specific type of cell deficiency is isolated.
Leukocyte disorders involving a certain type of white blood cells can be the following:
- Neutropenia . In neutropenia, there is an insufficient number of neutrophils, such as leukocytes, which fight off infections, fungi and bacteria. Neutropenia can be caused by cancer, as well as diseases, disorders or infections that damage the bone marrow. In addition, certain medications and poisoning can also cause neutropenia.
- Lymphocytopenia . In this form of leukopenia, the number of the type of white blood cells that, among other things, protects the body from viral infections, decreases. Lymphocytopenia may occur as a result of genetic predisposition. It can also be associated with certain diseases or act as a side effect after taking certain medications or using other treatments.
- Violations of monocytes . Monocytes help get rid of dead or damaged tissues and regulate the body's immune response. Infections, cancer, autoimmune diseases and other conditions can cause an increase in the number of monocytes. Reducing the number of these cells is often the result of the use of toxic substances, chemotherapy and other causes.
- Eosinophilia . With this violation, there is a greater number than usual of eosinophilic cells that fight various pathogens. Eosinophilia can be caused by many conditions and disorders, most often an allergic reaction or a parasitic infection.
- Basophilic disorders. Basophils make up only a small number of leukocytes, but they play a role in wound healing, deterring infection and allergic reactions. A decrease in the number of basophils may occur as a result of allergic reactions or infections. The increase in the number of these cells can be caused by certain types of blood cancer or other disorders.
The symptoms of leukopenia in adults are most often absent, but sometimes they coincide with signs of infection, so you should be wary when you see:
- Shortness of breath
If an intravenous access device (catheter) is used, it is worth checking if there is redness, swelling, pain or purulent discharge at the injection site. Against the background of a low AKD, redness or other signs of inflammation may not be detected, but an infection will still develop.
Video: What Is Leukopenia and What Causes It?
Leukopenia in the blood: causes
The most common causes of leukopenia are recent infections, chemotherapy, radiation therapy, and HIV (Merck 2012a).
Leukopenia can also be caused by certain drugs, such as the antipsychotic clozapine and the antibiotic minocycline (Ahmed 2007; Latif 2012). The most common type of neutropenia is caused by drugs in the form of chloramphenicol (an antibacterial drug). Its use is often associated with a decrease in the number of neutrophils and the induction of aplastic anemia (Paez 2008).
Leukopenia is a common side effect of anticancer drugs, as these drugs affect rapidly dividing cells (including neutrophils) (Merck 2012a). As a result, the production of young leukocytes is reduced by the action of these drugs, which ultimately leads to leukopenia, a common or some particular cell type.
Like anemia, an enlarged spleen (splenomegaly) can also cause leukopenia through increased clearance / destruction of leukocytes (He 2011).
What is blood leukopenia in children?
In childhood, neutropenia is most common, and is often the result of a viral infection. During virus multiplication, neutrophil production decreases, which can lead to neutropenia. When the infection passes, the number of neutrophils returns to normal, so the pediatrician often recommends repeating a blood test after a week or two. If neutropenia persists, the child may be referred to a hematologist to determine the cause of the disorder.
The lower limit of the norm of leukocytes in the blood of children, depending on age
|Have a newborn||10 x 10 ^ 9 / l|
|In 1 month||8 x 10 ^ 9 / l|
|In 1 year||7 x 10 ^ 9 / l|
|In 5 years||6 x 10 ^ 9 / l|
|In 15 years||5 x 10 ^ 9 / l|
Features of leukopenia in children
Autoimmune neutropenia in children can be called chronic benign neutropenia of childhood. This condition is similar to immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA). Despite the fact that the bone marrow produces neutrophils normally, the body incorrectly produces antibodies to neutrophils, which are involved in their destruction. This leads to neutropenia.
Pediatric autoimmune neutropenia usually occurs between the ages of 6 and 15 months, but can occur at any age, even in adulthood. Autoimmune neutropenia in combination with ITP or AIHA is called Evans syndrome.
Symptoms of leukopenia in children
Most children with autoimmune neutropenia do not have any symptoms. This is due to the fact that, despite the extremely low number of neutrophils, serious infections are rare.
Neutropenia can be detected by routine blood tests and be secondary to an ear or respiratory infection. Some children may have mouth ulcers or skin infections and then neutropenia is also determined.
How to treat leukopenia in the blood?
Treatment of neutropenia with fever depends on the general clinical condition of the patient. Pharmaceutical preparations that can be used on medical advice:
- Antibiotics such as ciprofloxacin (Cipro®), amoxicillin / clavulanate (Augmentin®), ceftazidime (Fortaz®), piperacillin / tazobactam (Zosyn®) and vancomycin (Vancocin®) (Macartney 2007). The goal of antimicrobial therapy is to prevent further infection, since neutropenia is associated with significantly increased susceptibility to various pathogens.
Under certain conditions, when leukopenia may develop during chemotherapy, prophylactic granulocyte colony-stimulating factors (for example, Neupogen®) and / or granulocyte macrophage colony-stimulating factors (for example, sargramostim [Leukine®]) may be prescribed. These drugs stimulate the bone marrow, resulting in an increase in the number of leukocytes, including neutrophils. In this case, patients can continue chemotherapy without the need to reduce the dose due to side effects. As a result, therapeutic results are improved.
It is important to note that the European Organization for Research and Treatment of Cancer recommended considering these drugs in all patients before starting chemotherapy, especially if there is an increased likelihood of leukopenia. For example, elderly patients or patients with a low number of neutrophils fall into this risk group. Also included are those who have already had neutropenia with fever after previous courses of therapy.
New treatments for leukopenia
Within 24 hours after chemotherapy, granulocyto-stimulating factor filgrastim is administered daily by subcutaneous injection for 2 weeks. On the contrary, a drug such as empegfilgrastim (Extimia®), which is a derivative of filgrastim, is administered only once. This became possible due to molecular modification of the drug, which significantly prolonged the time during which it remains biologically active. Thus, with the help of the newest means, more cancer patients were able to undergo treatment or use medicine to prevent febrile neutropenia.
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