Absolute Neutrophil Count (ANC) and Neutropenia

Symptoms of neutropenia

Neutropenia usually does not cause symptoms on its own. Instead, symptoms occur when an infection develops. Signs of infection may include: 

• Fever 
• Chills 
• Sore throat 
• Mouth sores 
• Cough 
• Redness or swelling around a wound 

Contact your health care provider or go to the Emergency Room right away if you notice fever or other signs of infection in your child. 

Causes of neutropenia

Neutropenia can have several causes. These include:

• Cancers that involve the bone marrow, such as leukemia and some lymphomas
  
• Bone marrow disorders, including aplastic anemia and myelodysplastic syndromes
  
• Autoimmune diseases, such as lupus or rheumatoid arthritis
  
• Infections, especially viral infections, which can lower neutrophil counts for a short time
  
• Treatments including chemotherapy, radiation therapy, and certain medicines
  

Tests for neutropenia

A complete blood count (CBC) test with differential is a simple blood test that is used to monitor neutrophil counts. On most blood count test reports, the ANC is already calculated for you. 

Other tests may be used to learn more about the cause of neutropenia, such as a bone marrow aspiration and biopsy.  

Treatment of neutropenia

The treatment for neutropenia depends on the cause or whether neutropenia is a result of an underlying health condition. 

Your care team may prescribe antibiotics to help prevent infection or medicines to help increase neutrophil counts.

If your child’s ANC is too low, your care team may decide to delay chemotherapy or other treatments until their counts improve. In some cases, your child may have to be hospitalized. Each hospital has its own guidelines for patients with low ANCs.

How to manage neutropenia

If your child has neutropenia, they are at risk for infections, particularly bacterial and fungal infections. Even minor infections can become serious when the ANC is low. 

It is important to take steps to help prevent infection: wash hands often, limit exposure to germs, avoid close contact with people who are sick, and get the vaccines recommended by your care team. 

The activities your child can do may depend on their neutrophil counts. Depending on your child’s ANC and overall health, your care team may recommend avoiding crowded public places, staying home from school, or wearing a face mask. Talk to your care team about your child’s risk of infection, signs to watch for, and when to seek medical care. 

Questions to ask your care team

• What is my child’s ANC, and what do those numbers mean?
  
• What is the cause of my child’s neutropenia?
  
• How will my child’s counts be monitored? 
  
• Will my child need treatment for neutropenia?
  
• What signs and symptoms of infection should we watch for?
  
• What precautions are needed based on test results?