What neutropenia means
The absolute neutrophil count (ANC) defines severity: mild, moderate or severe. Severe neutropenia carries the highest risk of serious infection, especially when it lasts more than a few days.
Neutropenia can be temporary, such as after chemotherapy or a viral illness, or persistent due to marrow disorders, autoimmune conditions, medicines or inherited syndromes.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
Causes and assessment
The review covers medicines, chemotherapy, infections, autoimmune disease, nutritional deficiencies, alcohol use, splenomegaly and family history. A repeat blood count and blood film confirm the finding.
Bone marrow examination, antibody testing and vitamin studies are added when the cause is unclear or the neutropenia is severe or persistent.
- Repeat CBC with differential and blood film
- Medication and chemotherapy review
- B12, folate and copper where indicated
- Marrow examination for persistent or severe cases
Prevention and treatment
Care includes infection-prevention advice, vaccination review, prompt treatment of fever and, in selected cases, granulocyte colony-stimulating factor (G-CSF). Antibiotic prophylaxis is used only in specific situations.
Fever in a patient with severe neutropenia is a medical emergency. Do not wait for a routine appointment; go to an emergency department and tell the staff about the low neutrophil count.
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, marrow, flow cytometry and molecular reports.