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Neutropenia: A Serious and Frequent Chemotherapy
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Many cancer patients worry about possible side effects
of chemotherapy. A Roper Starch survey of chemotherapy patients
found that prior to starting treatment, 32 percent reported
surviving cancer as their biggest concern versus 40 percent
who said side effects were their biggest concern. |
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This concern is warranted, as about half of cancer chemotherapy
patients develop neutropenia,23
which places them at risk for life-threatening infections.
Infections may require hospitalization and can delay
chemotherapy treatment and reduce its effectiveness. |
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What is neutropenia? |
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Neutrophils are the body's primary defense against infection.
They are attracted to the sites of infection or inflammation,
where they can destroy invading microbial organisms in several
different ways, including phagocytosis, oxygen-dependent activities,
and oxygen-independent activities. Neutrophils, infection-fighting
white blood cells (WBCs), are the major component of the white
blood cell-count constituting about 59% of the total.24 |
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Neutropenia is a severe drop in these infection-fighting
WBCs. A common side effect of some kinds of chemotherapy,
neutropenia is serious because: |
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Thousands of patients are hospitalized for neutropenia
each year - this in an age when many cancer patients
receive chemotherapy treatment as outpatients. |
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The majority of patients with certain tumors who develop
neutropenia will either have their chemotherapy postponed
or will have their dose decreased, both of which can
reduce survival rates.25,26 |
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In some cases, neutropenia can be deadly. |
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What are the symptoms of neutropenic infection? |
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There are some obvious signs and symptoms
of neutropenic infection, including: |
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Fever greater than 100.4°F (38°C) |
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Chills/sweating |
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Sore throat or cough |
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Mouth ulcers |
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Diarrhea or burning sensation during urination |
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Redness, pain, or swelling around a wound or sore |
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How is it diagnosed? |
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During cancer treatment, laboratory tests
are typically used to closely monitor a patient's white
blood cell count and other indicators for signs of compromised
immune function. Neutrophils are measured in terms of an "absolute
neutrophil count" (ANC). The normal range for neutrophils
in healthy patients is between 2,500 and 6,000 per cubic
millimeter of blood. An ANC below 2,000 qualifies as neutropenia
and increases a patient's risk of infection. An ANC below
500 places a patient at severe risk for infection.27
White blood cell counts generally reach their lowest point
approximately 10 to 14 days after chemotherapy, and
it may take 3 to 4 weeks, or sometimes longer, for
white blood cells to replenish themselves naturally. |
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How is neutropenia managed? |
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The management of neutropenia includes
strategies to avoid infections, detect them early, and
respond to them promptly and aggressively, as well as
therapies to help restore immune system function. |
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Patients being treated for cancer must be careful to reduce
their risk of infection by taking a variety of precautions,
such as washing their hands frequently, avoiding exposure
to people with infections, and taking care to avoid even
small cuts or tears in the skin. Patients must also remain
alert to early signs of infection, especially fever. If
infection does occur, it is considered a medical emergency.
Patients must often be admitted to the hospital and started
immediately on broad-spectrum antibiotic or antimicrobial
therapy. |
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A prescription medicine called Neulasta®
(pegfilgrastim) helps stimulate the bone marrow to produce
more infection-fighting white blood cells. |
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