Neutropenia involves having lower-than-normal levels of neutrophils (a type of white blood cell) in your blood. It’s especially common among people receiving cancer treatments, like chemotherapy. Neutrophils help fight infections. If you have neutropenia, it’s important to take extra precautions to avoid germs that may make you sick.
Neutropenia (noo-troh-PEE-nee-uh) refers to lower-than-normal levels of neutrophils in your blood. A neutrophil is a type of white blood cell that your bone marrow primarily makes. White blood cells in general, and neutrophils in particular, fight infections in your body. Neutrophils destroy germs that cause infections, like viruses and bacteria.
Not having enough neutrophils makes it harder for your body to fight germs and prevent infections. In severe cases, even bacteria that a healthy body typically tolerates (like the bacteria in your mouth and intestines) can make you sick.
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Neutropenia gets classified as mild, moderate, or severe, depending on the number of neutrophils in a blood sample. The lowest normal limit for adults is about 1,500 neutrophils per microliter of blood by many standards. (Some put the cut-off at 1,800 per microliter.) The range of neutrophil numbers is:
Neutropenia can also be classified as acute (temporary or short-lasting) or chronic (long-lasting), congenital (a condition you’re born with) or acquired (a condition that happens over time).
Benign ethnic neutropenia (BEN) is a chronic (long-lasting) congenital (present from birth) form of neutropenia that’s most common in people of African, Middle Eastern and West Indian descent. Although neutrophil counts are below 1,500 with this type of neutropenia, people with BEN are not at increased risk of infection.
Neutropenia’s effects vary depending on your neutrophil count. With mild neutropenia, you may not experience any symptoms. You may learn you have neutropenia incidentally during a blood test for another condition. Moderate to severe neutropenia may increase your risk of infection. Without treatment, severe neutropenia can be life-threatening.
Neutropenia happens when your bone marrow doesn’t make enough neutrophils, when your neutrophils break down too soon or when neutrophils get destroyed.
Any of the following can cause neutropenia.
Chronic idiopathic neutropenia is a specific type of neutropenia that doesn’t have a clear cause.
Cancer treatments, like chemotherapy, destroy cancer cells, but they may also destroy healthy neutrophils and the bone marrow that makes healthy white blood cells. Neutropenia is common during chemotherapy treatments. Neutrophil levels dip to their lowest numbers within the first two weeks following treatment before rising again.
It’s crucial to take extra precautions to avoid infections during this vulnerable time.
Neutropenia doesn’t cause symptoms, but the infections that may result from having neutropenia can. Repeated infections may also be a sign of neutropenia.
Symptoms may include:
If you have mild neutropenia, your body may have enough neutrophils to fight infections. In that case, you may not notice or develop any symptoms.
The most common test is a simple blood test called a complete blood count (CBC) with differential. Your healthcare provider will likely perform this test regularly to monitor your neutrophil levels if you receive chemotherapy.
Your healthcare provider may order additional tests if they’re unsure what’s causing your neutropenia. For instance, they may take a sample of your bone marrow and examine the cells under a microscope. This test can help your provider tell if neutrophils are developing abnormally in your bone marrow or being destroyed after they’re produced. This information can help your provider establish a diagnosis.
Some types of neutropenia might not require treatment. Other treatment options depend on what’s causing your low neutrophil levels.
Treatments may include:
If your medicine is causing neutropenia, your provider might tell you to stop taking it, or they may adjust your dose.
You can’t prevent the types of neutropenia you’re born with. If you’re receiving chemotherapy and your healthcare provider is worried about your low neutrophil levels, they may delay your next round of chemo or reduce your dose. They may also recommend getting injections of G-CSF to boost your white blood cell production, which increases neutrophils.
You can take precautions to prevent infections if you know your neutrophil levels are low.
Many of these tips apply to anyone who’s trying to keep from getting sick. If you have neutropenia, you’ll need to take extra care to avoid infection. Ask your provider about additional ways to prevent infection based on your lifestyle and health.
Neutropenia can be treated, so the outlook is good for most people. It’s essential to prevent infections and (if you do get sick) treat infections promptly.
If you’re receiving chemotherapy or have any condition that makes you vulnerable to neutropenia, see your healthcare provider immediately if you notice these symptoms or contact your provider immediately for instructions on what to do:
A note from Cleveland Clinic
Your experience of neutropenia will depend on what’s causing your low neutrophil count. If your levels are low because of a recent infection, they’ll likely return to normal once your body has had time to recover. If your neutropenia results from a chronic condition or chemotherapy treatment, your provider may monitor your levels regularly to prevent complications from infections. Ask your provider if your neutropenia will require more frequent check-ups to ensure you remain infection-free and if you require medications to help prevent infections.
Last reviewed by a Cleveland Clinic medical professional on 05/27/2022.
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