Neutropenia is an abnormal decrease in white blood cells most often resulting from a viral infection or exposure to certain drugs or chemicals. According to the Neutropenia Support Association, up to one third of patients who receive chemotherapy become neutropenic. The most common side effect of neutropenia is high fever. Patients whose body temperature rises above 101.5 degrees Fahrenheit while undergoing chemotherapy are encouraged to contact their physicians immediately to avoid potentially life-threatening effects of neutropenia.
For many breast cancer patients, chemotherapy is administered with or without breast surgery or other treatments to kill cancerous cells. Because chemotherapy is a systemic treatment, the drugs travel throughout the body to target cancer cells that may have spread past the breast. The human body is made up of red and white blood cells. Red blood cells carry oxygen to the lungs and different parts of the body while white blood cells protect the body from infection. Neutrophils, one common group of white blood cell produced in the bone marrow, divide and multiply quickly just like cancer cells. Since chemotherapy drugs aim for cancer cells with a high rate of reproduction, many of these neutrophils are also destroyed during treatment, resulting in neutropenia. Neutropenia is defined as a sharp reduction of neutrophils.
Patients with neutropenia tend to develop infections easily because their white blood cell count is too low to ward off threats to the body (such as foreign bacteria). Most infections occur in the lungs, mouth, throat, sinuses and skin. Some patients experience painful mouth ulcers, gum infections, ear infections, periodontal disease (disease of the tissues surrounding the teeth) or infections of the urinary tract, colon, rectum, or reproductive tract.
Symptoms of neutropenia may include:
- sore throat
- cough or shortness of breath
- diarrhea or loose bowels
- nasal congestion
- unusual vaginal discharge or itching
- burning during urination
- shaking chills
- redness, swelling or warmth at the site of an injury
Both men and women may develop neutropenia as a result of chemotherapy or another viral infection. Health care professionals are able to determine if a patient is neutropenic by analyzing the blood and calculating the absolute neutrophil count (ANC). The normal body contains between 2500 and 6000 cells per cubic millimeter. If a patient's ANC is 1000 or less, he or she is considered to be neutropenic. A patient with ANC less than 500 cells per cubic millimeters is considered a severe neutropenic at great risk of developing infections.