Ways To Treat And Prevent Neutropenia
Neutropenia is a medical condition in which the body has an abnormally low amount of neutrophils. Neutrophils are a form of white blood cells, and having too few of them raises a patient's risk of infection. While neutropenia is rare in the general population, patients undergoing chemotherapy treatment for cancer commonly develop it. Sometimes, individuals with neutropenia may not have any symptoms. If symptoms are present, they typically include a fever, mouth ulcers, abscesses, wounds that are slow to heal, and a sore throat. Doctors perform blood tests to check for the absolute neutrophil count to diagnose neutropenia. At least two blood tests taken on different days are required to confirm a neutropenia diagnosis. Other than chemotherapy, common causes of neutropenia include radiation treatment, tuberculosis, leukemia, conditions that affect bone marrow, viral infections, and nutritional deficiencies. The methods outlined below are often recommended in the prevention and treatment of neutropenia.
Granulocyte Colony-Stimulating Factor
Granulocyte colony-stimulating factor (GCSF) is a type of growth factor most often used in the treatment of neutropenia for cancer patients. GCSF forces the bone marrow to produce neutrophils, lowering a patient's risk of infection. Granulocyte colony-stimulating factor is typically given to cancer patients who have just received high doses of chemotherapy, and it is also given to individuals awaiting a stem cell transplant. GCSF is administered via an injection under the skin, which can be given in the arm, stomach, or thigh. Patients may be taught how to administer these injections themselves. For certain patients, doctors may recommend GCSF be given in the clinic as an intravenous drip.
Common side effects of granulocyte colony-stimulating factor include headaches, bone pain, liver changes, bruising, nosebleeds, bleeding gums, and diarrhea. Less commonly, patients may experience constipation, swollen hands or feet, an enlarged spleen, coughing, and pain while urinating. Patients who receive GCSF will be closely monitored at follow-up appointments and should report any concerns or side effects to their healthcare team.
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Stem Cell Transplant
A stem cell transplant may be recommended for patients with severe cases of neutropenia. The transplants are particularly helpful for patients with neutropenia caused by problems with bone marrow. Patients who have transplants are required to complete a number of medical tests before the transplant can take place. These tests are done to ensure patients are physically and mentally healthy enough to undergo the procedure. First, doctors will perform a complete health history and a physical examination. Patients will have CT scans, blood tests, electrocardiograms and other heart tests, chest x-rays, pulmonary function tests, a bone marrow biopsy, and HLA tissue typing. Patients will also have psychological evaluations, and they will need to identify a primary caregiver to help them during the transplant and recovery process.
Stem cell transplants are given through intravenous infusion in the hospital, just like a regular IV. Patients are awake for the procedure, and the infusion does not hurt. Potential side effects of transplantation include fever, chills, low blood pressure, reduced urine output, and a feeling of tightness in the chest. Following the transplant, patients enter a phase known as engrafting, which lasts between two to six weeks. If the transplant has been successful, the transplanted stem cells multiply and make new blood cells during this period, eventually bringing patient's blood counts back within the normal range. Patients have daily appointments at the hospital or transplant center for monitoring during this time.
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