Neutrophils die continuously from age or from fighting infections, and your bone marrow must make new neutrophils to replace them. When something reduces production of neutrophils in your bone marrow, the neutrophil count will drop and may become dangerously low. Prescription medications or HCV antiviral drugs such as interferon can cause neutropenia. In almost all cases, drug-induced neutropenia (low white count) resolves after the agent is stopped or its dosage is reduced.
Normal Adult Range: 3.8 - 10.8 thous/mcl
Optimal Adult Reading: 7.3
Higher ranges are found in children, newborns and infants.
Neutrophils are a major part of your body’s defense against bacterial infections. When the WBC is low, there may not be enough neutrophils to defend you against bacterial infections. Neutrophils are made in the bone marrow and circulate in the bloodstream. Neutrophils move out of the blood vessels into the infected tissue to attack the bacteria. The pus in a boil (abscess) is made up mostly of neutrophils. Normally a serious bacterial infection causes the body to produce an increased number of neutrophils, resulting in a higher than normal WBC.
Physicians like to keep the neutrophil count (absolute neutrophil count = (ANC) above 750, patients do not typically develop infections. However, if neutrophil counts go below 500/µL interferon is suspended.
Neutrophil% x White Blood Cell = Absolute Neutrophil Count
Ask The Experts
In an HCV-infected patient with neutropenia who is receiving pegylated interferon and ribavirin, what is the recommended absolute neutrophil count (ANC) target range when treating with filgrastim (Neupogen)?
Clinicians who decide to use filgrastim should carefully monitor white blood cell counts after filgrastim and should use the lowest effective dose.
White Blood Cell Chases Bacteria
It's dinner time for this white blood cell. White blood cells are cells of the immune system defending the body against both infectious disease and foreign materials.
Mental health problems (such as depression, thoughts about suicide, suicide attempts and relapse of drug abuse or drug overdose, all of which can lead to death. Other problems include thoughts of homicide or hurting other people, irritability, anxiety, aggressiveness, bipolar disorders, mania, and hallucinations)
Blood problems (like a drop in blood cells leading to increased risk for infections, bleeding and/or heart or circulatory problems). Low levels of red blood cells can cause death in patients taking COPEGUS. Most blood counts may be reduced including white blood cell, red blood cell, platelets, hemoglobin, neutrophil, and lymphocyte counts.
Other blood disorders
Problems with pregnancy
Lung problems (like trouble breathing, pneumonia, inflammation of lung tissue, and high lung blood pressure), sometimes requiring a machine to breathe for you and/or causing death
Eye problems (blurred, loss of vision, and retinal detachment)
Autoimmune problems (sarcoidosis, rheumatoid arthritis, systemic lupus erythematosus, psoriasis, and thyroid problems, such as hyperthyroidism and hypothyroidism)
Heart problems (including high or low blood pressure, chest pain, fast heart rate, and heart attacks) which can lead to death
Stomach pain (stomach or corneal ulcers)
Rash with fever or blisters
Weakness, loss of coordination, numbness, and difficulty speaking due to stroke, including patients with no known risk for stroke
Liver problems (rarely, liver function worsens) including an increased chance of liver failure in patients with cirrhosis. Patients with both the hepatitis C virus and HIV have an increased chance of liver failure during PEGASYS treatment. Change in a blood test that measures liver inflammation occurs more often in patients with hepatitis B. If you have a rise in this blood test you may need to be watched more closely with additional blood tests. Severe liver damage can lead to death
Colitis (inflammation of the colon, which can cause abdominal pain, bloody diarrhea, and fever) which can lead to death
Inflammation of the pancreas, muscles, and bile ducts which can lead to death
Blood sugar problems such as high or low blood sugar and diabetes
Bacterial, viral, fungal infections (such as in the blood, bones, heart, kidneys and lungs) which can lead to death
The most common side effects are:
Flu-like symptoms (including fever, chills, muscle aches, joint pain, headaches, tiredness)
Upset stomach (like nausea, vomiting, taste changes, diarrhea)
Skin problems (like rash, dry or itchy skin, or redness and swelling at injection site)
Hair thinning or loss (temporary)
Mental health problems (such as depression, difficulty sleeping, irritability, and anxiety)
Anorexia or loss of appetite leading to weight loss
Tell your doctor immediately if you think you or your partner may be pregnant or if any of these symptoms occur.