Low White Blood Cell Count (Leukopenia)

What is low white blood cell count (leukopenia)?

Every day, our bodies produce about 100 billion white blood cells (leukocytes). Leukocytes help defend our bodies against intruders like viruses and bacteria that may cause infections.

In leukopenia (pronounced “luke-a-PEE-ne-ah”), you have lower-than-normal numbers of white blood cells. Specifically, you have fewer neutrophils than normal.

Neutrophils are white blood cells that act as your immune system’s first line of defense. Without enough white blood cells, including enough neutrophils, you’re more vulnerable to developing infections.

A white blood cell count that’s less than 4,000 cells per microliter of blood is a low white blood cell count. Normal white blood cell counts vary depending on age and sex. For example, the white blood cell count for men, people designated male at birth and children is 5,000 to 10,000 cells per microliter of blood. The normal range for women and people designated female at birth is 4,500 to 11,000 microliters of blood.

Is leukopenia a kind of cancer?

No, it’s not but there’s a connection between leukopenia and cancer. Cancer treatments may cause leukopenia.

Does leukopenia lead to leukemia?

No, but leukemia may cause leukopenia. Leukemia affects your blood cells, including white blood cells. Your bone marrow makes blood cells.

In leukemia, your body makes abnormal blood cells that multiply and divide. The abnormal cells eventually outnumber healthy cells, including healthy white blood cells. That leaves your body with lower-than-normal levels of white blood cells or leukopenia.

Who is affected by low white blood cell count (leukopenia)?

Your white blood cell counts frequently rise and fall. Leukopenia happens when the number of white blood cells in your blood drops and doesn’t rise. People with certain medical conditions or receiving cancer treatments often have leukopenia.

What causes leukopenia?

People may develop leukopenia because they have certain medical conditions, take certain medications or have malnutrition and/or don’t get enough of certain vitamins. Medical conditions include:

• Bone marrow disorders: Multiple myeloma and aplastic anemia are examples of bone marrow disorders that cause leukopenia.
• Autoimmune diseases: Autoimmune diseases happen when your immune system attacks your body. Lupus and rheumatoid arthritis are examples of autoimmune diseases.
• Infections: Human immunodeficiency virus (HIV) may cause leukopenia.

What are leukopenia symptoms?

Leukopenia doesn’t have symptoms but it can cause infections that have the following symptoms:

• Fever and chills.
• Swelling and redness.
• Mouth sores.
• Red or white patches in your mouth.
• Sore throat.
• Severe cough or shortness of breath.
• Painful urination or pee that smells bad.
• Diarrhea.
• Cuts or sores that drain pus.
• Unusual vaginal discharge or itching.

How do healthcare providers diagnose leukopenia?

Healthcare providers diagnose leukopenia by doing complete blood counts (CBCs). They may do additional tests if they think you may have an infection. Those tests may include:

• Urine tests: These tests may help healthcare providers determine what’s causing your infection.
• Chest X-ray: They may order this test if they think you have pneumonia.

How do healthcare providers treat leukopenia?

Healthcare providers treat the underlying cause. For example, if you have leukopenia because you have an infection, they may use antibiotics or antiviral drugs to fight the infection. Other treatments may include:

• Growth factors: These drugs encourage your bone marrow to make more blood cells. In this case, growth factor medication may boost white blood cell production.
• Delaying chemotherapy: If you’re receiving chemotherapy for cancer, your healthcare provider may recommend delaying treatment until your white blood cell count increases.

What can I do to prevent leukopenia?

You may not be able to avoid leukopenia. However, taking care of your overall health and avoiding infection are good ways to reduce your risk. Some suggestions include:

• Wash your hands frequently with soap and water, or use an alcohol-based hand sanitizer.
• Stay up-to-date on all vaccines, including shots for the flu and COVID-19.
• Avoid people who are sick or crowds where you might come into close contact with people who are sick.
• Avoid injuries like scrapes, tears or cuts (including tattoos and piercings), and care for wounds immediately if your skin is damaged.
• Prevent the spread of germs by washing fruits and vegetables, keeping meats away from other foods, preparing meals in a clean kitchen and cooking foods to the proper temperature.
• Don’t share utensils, cups, food or drinks with others.
• Don’t share towels, razors or toothbrushes with others.
• Wear gloves if you’re gardening or working in the yard.
• Avoid picking up pet waste or changing a newborn’s diaper. (If you can’t avoid these tasks, wear gloves and wash your hands when you’re done.)
• Avoid lakes, ponds, rivers and hot tubs.
• Be sure to take the medication your healthcare provider prescribed that will help prevent infections.

What can I expect if I have leukopenia?

Your prognosis, or expected outcome, depends on why you have leukopenia. For example, you may have leukopenia because you have a viral infection. In that case, your white blood cell count should return to normal once you’re over your infection. If your white blood cell count is low because you’re receiving cancer treatment, your prognosis depends on your cancer diagnosis and treatment.

When should I contact my healthcare provider?

Leukopenia increases your risk of developing infections, so you should contact your healthcare provider if you have leukopenia and think you may have an infection.

A note from Cleveland Clinic

Leukopenia happens when your white blood cell levels are lower than normal. There are many reasons why your white blood cell level may drop. For example, you may be receiving life-saving cancer treatment that lowers your white blood cell levels. You may have an autoimmune disorder like lupus. If you have leukopenia, you’re at risk of infections. If you know you have leukopenia, talk to your healthcare provider about ways to fend off infections.