Managing white blood cell counts during chemotherapy 

 close up blur medical IV drip with tubing hanging on standing in operation surgery room , waiting for transfer saline solution to patient , medical therapy concept

Managing white blood cell counts during chemotherapy 

Anyone who has ever gone through chemotherapy for treating cancer knows how important white blood cell counts (WBCs) are.   It’s not uncommon for a person to develop leukopenia or low white blood cell counts at certain times of chemotherapy.  The reason for this is chemotherapy works by killing the fastest-growing cells in the body including WBCs.  White blood cells are needed to fight infections and if the count is low, your immune system is weakened increasing the risk of infection and can delay receiving cancer treatments until the count increases.  Usually the blood counts do return to normal before the next round of chemotherapy and when the cancer treatment is completed. 

Understanding white blood cells

The normal range for white blood cells is 4,500-10,000 WBC per microliter (mcL).  Our WBC count makes up for only about 1% of our blood, but what a significant quantity that is in terms of keeping us healthy.  These tireless cells work round the clock to help fight off infections, viruses, bacteria or any other foreign invader that want to cause us harm.  WBCs are an important component of our blood system and they are made up of different types of WBCs including monocytes, lymphocytes, neutrophils, basophils, and eosinophils.

When our body is in distress with a certain area being under attack, WBCs rush in to help destroy the harmful substance and prevent illness. Our bone marrow produces WBCs which are then stored in the blood and lymphatic tissues.  The lifespan of a WBC is about one to three days so the bone marrow is constantly kept busy making them.

A person who has radiation to the bones can experience chronic suppression of blood cell production resulting in low counts.  Other cancer patients receiving treatment to another area of the body will recover their WBCs more quickly but the amount of time it takes for WBCs to return to normal will vary from person to person.

Why is it important to monitor your blood cell counts?

Being able to maintain an adequate WBC count is crucial during cancer treatments. Low blood cell counts can lead to serious complications that may delay your next round of treatment. Monitoring your blood cell 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. Infection can lead to death in severe cases.

Even a mild infection can delay your chemotherapy treatment, since your doctor may wait until your infection is cleared and your blood cell counts go back up before you continue. 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 cancer 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. Dangerous internal bleeding can occur.

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 to help maintain white blood cell counts

Even though there is no diet or specific foods a person can eat to increase production of WBCs, having leukopenia means there are steps to take keeping yourself as healthy as possible while the counts are low.  The neutrophils are the WBCs that fight off bacterial infection – when neutropenia (low levels of neutrophils) develops this makes a person more susceptible to infections.  Protect yourself from developing a low WBC count by following these suggestions:

·      Practice good hygiene of hand-washing and food safety

·      Use an anti-bacterial soap with warm water, scrubbing your hands for 15-30 seconds several times daily and always before you prepare and eat food.  Wash hands after shaking hands with anyone and avoid touching your face, particularly your nose, eyes and mouth.

·      Avoid raw meat, eggs and fish, moldy or expired food, unwashed or moldy fruit and vegetables, and unpasteurized beverages including milk, fruit and vegetable juice, beer, as well as unpasteurized honey.

·      Wash all fresh fruits and vegetables thoroughly before eating.

·      Consume good quality protein sources to help the body use the building blocks (amino acids) from protein to make new WBCs. 

·      Get adequate rest and sleep at night to help your body recover and recuperate from cancer treatments. 

·      Keep physically active if possible to help keep the immune system strong

·      Avoid people who are sick and stay away from crowds.

·      Avoid injury or any type of activity putting 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. Be gentle when brushing your teeth and blowing your nose.