Low blood cell counts: Side effect of cancer treatment
Your doctor may monitor your blood cell counts carefully during your cancer
treatment. There's a good reason you're having your blood drawn so often —
low blood cell counts put you at risk of serious complications.
What's measured in a blood cell count?
When checking your blood cell count, your doctor is looking at the numbers
and types of:
- White blood cells. These cells help
your body fight infection. A low white blood cell count (leukopenia)
leaves your body more open to infection. And if an infection does develop,
your body may be unable to fight it off.
- Red blood cells. Red blood cells
carry oxygen throughout your body. Your red blood cells' ability to carry
oxygen is measured by the amount of hemoglobin in your blood. If your
level of hemoglobin is low, you're anemic and your body works much harder
to supply oxygen to your tissues. This can make you feel fatigued and
short of breath.
- Platelets. Platelets help your
blood clot. A low platelet count (thrombocytopenia) means your body can't
stop itself from bleeding.
If you're undergoing certain cancer treatments that could cause low blood
cell counts, your doctor will likely monitor your blood cell counts regularly
using a test called a complete blood count (CBC). Low blood cell counts are
detected by examining a blood sample taken from a vein in your arm.
|What's being counted
|White blood cells (WBC)
||Below normal, especially below 1,000
||14.5-18 for men
12-16 for women
What causes low blood cell counts?
Cancer-related causes of low blood cell counts include:
- Chemotherapy. Certain chemotherapy
drugs can damage your bone marrow — the spongy material found in your
bones. Your bone marrow makes blood cells, which grow rapidly, making them
very sensitive to the effects of chemotherapy. Chemotherapy kills many of
the cells in your bone marrow, but the cells recover with time. Your
doctor can tell you whether your specific chemotherapy treatment and dose
will put you at risk of low blood cell counts.
- Radiation therapy. If you receive
radiation therapy to large areas of your body and especially to the large
bones that contain the most bone marrow, such as your pelvis, legs and
torso, you might experience low levels of red and white blood cells.
Radiation therapy is less likely to have a significant effect on your
platelet count. Radiation combined with chemotherapy increases your risk
of low blood cell counts.
- Cancers of the blood and bone marrow.
Blood and bone marrow cancers, such as leukemia, attack different parts of
your bone marrow. The cancerous cells can displace other cells in your
bone marrow, making it difficult for your bone marrow to produce the blood
cells your body needs.
- Cancers that spread (metastasize).
Cancer cells that break off from a tumor can spread to other parts of your
body, including your bone marrow. Some examples of cancers that can spread
to bone marrow include breast cancer, lung cancer and prostate cancer.
This is an unusual cause of low blood counts.
Why is it important to monitor your blood cell counts?
Low blood cell counts can lead to serious complications that may delay your
next round of treatment. Monitoring your blood counts allows your doctor to
prevent or reduce your risk of complications.
The most serious complications of low blood cell counts include:
- Infection. With a low white blood
cell count and, in particular, a low level of neutrophils (neutropenia), a
type of white blood cell that fights infection, you're at higher risk of
developing an infection. And if you develop an infection when you have a
low white blood cell count, your body can't protect itself. Even a mild
infection can delay your chemotherapy treatment, since your doctor may
wait until your infection is cleared and your blood counts go back up
before you continue. At times your doctor may choose to lower the dose of
chemotherapy you receive in order to decrease your chance of developing
serious low white blood cell counts. Your doctor may also recommend
medication to increase your body's production of white blood cells.
- Anemia. A low red blood cell count
is anemia. The most common symptoms of anemia are fatigue and shortness of
breath. In some cases fatigue becomes so severe that you must temporarily
halt your treatment or reduce the dose you receive. Anemia can be relieved
with a blood transfusion or with medication to increase your body's
production of red blood cells.
- Bleeding. Low numbers of platelets
in your blood can cause bleeding. You might bleed excessively from a small
cut or bleed spontaneously from your nose or gums. A low platelet count
can delay your treatment. You may have to wait until your platelet levels
go up in order to continue with chemotherapy or to have surgery.
How can you tell if you have low blood cell counts?
Unless your blood cell counts are very low, you probably won't experience
any signs or symptoms and you won't be able to tell that your blood counts are
down. That's why your doctor may order frequent blood tests to follow your
blood cell counts.
Ask your doctor whether your cancer treatment is likely to cause low blood
cell counts and what signs and symptoms you should be looking for. If you
notice any signs or symptoms of low blood cell counts, tell your doctor right
||What to look for
|Low white blood cell count
||Fever higher than 101 F
|Low red blood cell count
Shortness of breath
|Low platelet count
Heavy menstrual bleeding
How are low blood cell counts treated?
If you have low blood cell counts, your treatment will depend on which
counts are low and what's causing the low numbers. Common treatments include:
- Blood transfusions. Transfusions
help people with low levels of red blood cells and platelets. In a blood
transfusion you're given either red blood cells or platelets from people
who've donated blood.
- Medications. Your doctor may
prescribe medications, sometimes called "growth factors," that
encourage your body to produce more blood cells. Medications are also used
to prevent low blood cell counts in people who have a high probability of
experiencing complications of cancer treatment. Medications have benefits
and risks, so talk to your doctor about the possible side effects of drugs
used to boost blood cell counts.
- Stopping treatment. In severe cases
you may need to delay your cancer treatment until your blood cell counts
The type of treatment you receive will depend on your cancer treatment and
your physical condition.
How can you cope with low blood cell counts?
Take steps to keep your body healthy when you have low blood cell counts.
- Eat a balanced diet. Your body
needs all the vitamins and nutrients it can get to heal itself during and
after your treatment. Eat plenty of fruits and vegetables. If treatment
complications make eating difficult — for example, if you experience
nausea and vomiting or mouth sores — experiment to find foods you can
- Avoid injury. Many everyday
activities put you at risk of cuts and scrapes. A low platelet count makes
even minor abrasions serious. A low white blood cell count can turn a
small cut into a starting point for a serious infection. Use an electric
shaver rather than a razor to avoid nicks. Ask someone else to cut up food
in the kitchen. Be gentle when brushing your teeth and blowing your nose.
- Avoid germs. It's impossible to
avoid all germs, but avoid unnecessary exposure when you can. Wash your
hands frequently. Avoid people who are sick and stay away from crowds.
Have someone else clean the litter box, bird cage or fish tank. Don't eat
raw meat or eggs.
- Rest. If you feel tired, stop and rest.
Your body is working hard to fight the cancer cells and heal the healthy
cells damaged by your treatment. Don't feel guilty about taking time for
yourself and asking others to help you. Plan your most important
activities for the time of day when you feel most energetic.
Talk to your health care team about other ways you can cope with low blood
For more information on cancer visit The
Mayo Clinic website
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