Neutropenia

Neutropenia is a condition where you do not have enough neutrophils (a type of white blood cells) in your blood. White blood cells are part of your immune system. They help your body fight infections.

If you have neutropenia, you're at a higher risk of getting infections. The fewer white blood cells you have, the higher your risk of infection.

If you have neutropenia and get an infection, your body may struggle to fight it. This can be very dangerous.

Neutropenia can be:

• acute — comes on suddenly and may go away quickly
• chronic — lasts a long time
• cyclic — comes and goes

What is febrile neutropenia?

Febrile neutropenia means you have neutropenia and a body temperature of 38°C or higher. It is often a complication of cancer treatment. Febrile neutropenia can be life-threatening. It needs immediate medical attention.

Neutropenia itself does not have any symptoms. You may get a fever if you have an infection. This may be your only symptom, and you may not show other usual symptoms of an infection when you have neutropenia.

You may also get symptoms of bacterial infections in different parts of your body, including your:

• skin
• mouth and gums
• sinuses
• internal organs

There are many causes for neutropenia, such as:

• bacterial or fungal infections
• medicines
• an enlarged spleen
• autoimmune diseases such as lupus
• allergic reactions

Neutropenia can also be caused by:

• blood disorders — such as myelodysplastic syndromes (MDS) and leukaemia
• chemotherapy — a type of cancer treatment
• genetics — you can have neutropenia from birth, known as congenital neutropenia
• Mild neutropenia is normal for many people of African or Middle Eastern origin.

See your doctor if you know you have neutropenia, or if you have recently had chemotherapy, and you develop symptoms of an infection. This may include any of these symptoms:

• toothache, sores in your mouth or a sore throat
• fever, sweating or chills
• diarrhoea or pain in your anal region
• pain when urinating
• unusual vaginal discharge
• coughing or shortness of breath
• rash or swelling on your skin

Your doctor can diagnose you by referring you to do a blood test. You may need other tests such as a bone marrow test to find out why you have neutropenia.

Your treatment for neutropenia will depend on the cause and how severe it is. If you have mild neutropenia, you may not need any treatment.

If your neutropenia is caused by chemotherapy, your treatment may include:

• blood tests before each cycle of chemotherapy — to check your white blood cell levels. If they are low, they may delay your chemotherapy cycle or lower your dose.
• granulocyte colony stimulating factor (GCSF) injection — this helps your body make more white blood cells
• medicines including antibiotics, antivirals or antifungals — to reduce your risk of getting an infection

If you have febrile neutropenia, you will be admitted to hospital. You will be treated with antibiotics and your doctor will arrange blood tests for you.

Neutropenic diet

If you have neutropenia, you may need to follow a neutropenic diet to prevent complications. This diet focuses on food safety and involves:

• avoiding certain foods that are more likely to cause food poisoning
• storing and preparing food safely
• being extra careful with cleanliness to avoid bacteria, viruses, parasites or fungi

There are things you can do to protect yourself from getting life-threatening infections. Here are some tips to protect yourself:

• Wash your hands regularly after you eat, touch animals or touch anything dirty or used by other people.
• Stay away from people who are sick.
• Avoid large crowds and wear a mask if you cannot socially distance.
• Carefully clean any scratches or wounds you may have with soap and water.
• Avoid animal litter trays or waste.

Neutropenia increases your risk of serious infections. The lower your white blood cell count, the higher your risk of getting an infection. These infections can be life-threatening.

Febrile neutropenia emergency letter

If you've had chemotherapy and are at high risk of developing febrile neutropenia, you'll be given an emergency letter. Show this letter to the doctors treating you if you get febrile neutropenia.

Speak with your healthcare provider if you don't have a febrile neutropenia emergency letter.

You usually can't prevent neutropenia, especially if it's caused by medical treatments.

• The Cancer Council website offers information on neutropenia.
• The Leukaemia Foundation provides support and information about food safety and a neutropenic diet.
• Watch NSW Government Food Authority's video about the 4 golden rules of food safety.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

The Cancer Council website provides fact sheets and videos about cancer in several

languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Our Mob and Cancer offers information about cancer and support for living with cancer.