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About Cancer-Related Neutropenia

Neutropenia (New-tro-pee-nee-ah) is the term used to describe the condition when your neutrophil count in your blood is too low. Leukocytes (white blood cells) are the cells in your body that fight infections or germs. Neutrophils are a type of white blood cell that kills bacteria. Your bone marrow produces these cells along with other types of blood cells. Neutrophils are the first line of defense when your body needs to fight an infection, so in cancer patients they are monitored closely.

Why Neutrophils Are Important

Because the neutrophils are the first line of defense your doctor and nurses will be following your neutrophil count (meaning the number of neutrophils that you have available to fight an infection) as you go through treatments. They get these numbers from your blood tests, and will generally run a Complete Blood Count (CBC) several times during treatments and afterwards to monitor the balance of the different components of your blood, and how your body is responding to what it is being subjected to.

What is an Absolute Neutrophil Count (ANC)?

When monitoring patients' neutrophils, your caregivers rely on a count called the "Absolute Neutrophil Count (ANC)". This simply is a way to find out an estimate of the total number of neutrophils that you have available in your blood to fight off any possible infections. The formula that your healthcare provider uses to find your ANC is below:

(Total # of WBC) x (% of Neutrophils) = ANC

How ANC is calculated.

When calculating the Absolute Neutrophil Count (ANC) they multiply the total number of White Blood cells by the Percent of Neutrophils (sometimes also called polys or segs) and the bands.

  • Take the percent of neutrophils (may also be polys or segs) + percent bands = Percent
  • Convert the decimal by dividing by 100 (Example 52% = 52/100 = 0.52) *move the decimal 2 points to the left
  • Multiply this number by the total White Blood Cells (WBC)

(Total # of WBC) x (% of Neutrophils) = ANC

Example: WBC=4000, Neutrophils=50%, Bands=6%

  • 50+6=56
  • 56 divided by 100 = 0.56
  • 0.56 x 4000 = 2240 = ANC

What is an abnormal ANC?

An abnormal ANC is fewer than 1500 cells per mm3. The severity of neutropenia is categorized as mild with an ANC of 1000-1500 cells per mm3, moderate with an ANC of 500-1000 cells per mm3, and severe with an ANC of fewer than 500 cells per mm3. The risk of bacterial infection is related to the severity and duration of neutropenia. The longer you are neutropenic, the greater the risk that you will develop an infection.