Medical News Today: What is leukopenia?

Leukopenia is a condition where a person has a reduced number of white blood cells. This increases their risk of infections.

A person’s blood is made up of many different types of blood cells. White blood cells, also known as leukocytes, help to fight off infection. Leukocytes are a vital part of the immune system.

People who have leukopenia have fewer white blood cells than they should. This makes them more likely to get infections.

This article explores the effect leukopenia has on the body, what causes it, and the treatment options available.

What is leukopenia?

White blood cell surrounded by red blood platelets.
White blood cells help the body to fight infections. A person with leukopenia does not have enough white blood cells.

Leukopenia is a condition where a person has fewer white blood cells in their bloodstream than they should. Leukopenia is diagnosed with a blood test called a complete blood count or CBC.

A healthy white blood cell count is between 3,500 and 11,000 white blood cells per microliter. A person with leukopenia may have fewer than 3,500 white blood cells per microliter.

White blood cells are made in the bone marrow and are critical for the immune system. Having too few of them means the body is less able to fight off infections and diseases.

There are five types of white blood cells. Each helps to protect the body from a different kind of infection:

  • Neutrophils: These make up 55 to 70 percent of total white blood cells. They help fight off fungal and bacterial infections.
  • Lymphocytes: These are the second most common type of white blood cell. They protect the body from viral infections.
  • Basophils: These are the least common type of the white blood cells. They are involved in inflammatory reactions to allergens.
  • Monocytes: These are the largest of the white blood cells. They play a role in fighting off bacteria, fungi, and viruses. They also help mend tissue that has been damaged by inflammation.
  • Eosinophils: These fight parasites and play a role in allergic reactions and conditions, such as asthma.

There are five kinds of leukopenia, each one corresponding to the type of white blood cell that is affected.


Leukopenia vs neutropenia

The terms leukopenia and neutropenia are often used interchangeably. However, they refer to slightly different conditions.

Leukopenia is an umbrella term that refers to a reduction in any of the white blood cell types.

Neutropenia is a type of leukopenia but refers specifically to a decrease in neutrophils, the most common type of white blood cell.

A person’s neutrophil count is an important indicator of their infection risk.

An absolute neutrophil count (ANC) is a test that doctors may carry out to decide a person’s overall health. This test can help to diagnose conditions that include leukemia. It can also help assess the body’s response to treatments, including chemotherapy.


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Symptoms

Woman on sofa with blanket, suffering from fever, sweating, and chills.
A person with leukopenia may be more prone to infections, which may cause symptoms such as fever, sweating, and chills.

There are no specific symptoms of having a low white blood cell count. However, when someone has leukopenia, they are more likely to get infections. The symptoms of infection include:

A person with leukopenia may have other symptoms that relate to the cause of their low white blood cell count. The different causes of leukopenia are explored below.


Causes

There are several medical conditions that cause leukopenia by interfering with the production of white blood cells in the bone marrow.

Other conditions cause leukopenia by destroying white blood cells rather than affecting their production. Leukopenia may also be the result of some treatments and medications.

Conditions that may cause leukopenia

The following conditions may cause leukopenia:

  • Viral infections: Acute viral infections, such as colds and influenza may lead to temporary leukopenia. In the short term, a viral infection may disrupt the production of white blood cells in a person’s bone marrow.
  • Blood cell and bone marrow conditions: These can lead to leukopenia. Examples include aplastic anemia, overactive spleen, and myelodysplastic syndromes.
  • Cancer: Leukemia and other cancers may damage the bone marrow and lead to leukopenia.
  • Infectious diseases: Examples include HIV, AIDS, and tuberculosis. According to a 2015 study, women with tuberculosis are more likely to develop leukopenia than men.
  • Autoimmune disorders: Some of these kill white blood cells. Examples include lupus and rheumatoid arthritis.
  • Birth disorders: Also known as congenital disorders, these may lead to leukopenia. Examples include Kostmann syndrome and myelokathexis.
  • Malnutrition: Certain vitamin and mineral deficiencies may lead to leukopenia. Examples include deficiencies in vitamin B-12, folate, copper, and zinc.
  • Sarcoidosis: This is an overreaction of the immune system that leads to small areas of inflammation in the body. It can also affect bone marrow.

Treatments and medications that may cause leukopenia

Cancer treatments may affect a person’s white blood cell count, leading to leukopenia. Examples that may have this effect include:

Certain medications can also affect the number of white blood cells in someone’s blood and may lead to leukopenia. Medications that can have this effect include:

  • interferons to treat multiple sclerosis
  • lamotrigine and sodium valproate for epilepsy and as mood stabilizers
  • bupropion, an antidepressant and smoking cessation medication
  • clozapine, an antipsychotic medication
  • minocycline, a common antibiotic
  • immunosuppressants, such as sirolimus, mycophenolate mofetil, tacrolimus, and cyclosporine
  • steroids
  • penicillin

If a person is unsure of the generic name of the drug they are taking, and if it will affect their immune system, it is a good idea for them to ask a doctor.

Stages

If a person’s body is fighting off infection, this may affect their white blood cell count. They may have slightly fewer white blood cells circulating in their bloodstream. This condition is called pseudoleukopenia.

Pseudoleukopenia is the stage before leukopenia. If a person’s white blood cells continue to decrease, they may go on to develop leukopenia.


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Treatment

Young male doctor speaking with mature female patient.
Treatment is usually based on the specific cause of leukopenia.

If a medication is causing leukopenia, a doctor might recommend that a person stops taking it or tries a different type. A person should never stop or change their medication without first consulting a doctor.

If a person has cancer and their chemotherapy is causing leukopenia, they may need to pause their treatment to allow their white blood cells to replenish.

Treatments that use growth factors, such as granulocyte colony-stimulating factor, may help leukopenia. These are often used when chemotherapy is causing leukopenia or if the cause is genetic.

A 2015 study found that when chemotherapy was used alongside a drug called erlotinib, a tyrosine kinase inhibitor, the risk of leukopenia was much lower.

Management

The following home treatments and behaviors may help a person with leukopenia improve their condition and reduce their risk of infection:

  • eating a healthful diet
  • getting plenty of rest
  • avoiding cuts and scrapes
  • practicing good hygiene to avoid germs

Treatment may also be needed for any infections that result from a reduced white blood cell count. This might include antibiotics or antifungals.

Outlook

Treating leukopenia may involve pausing medication or treatments. This may be problematic if the underlying condition is serious, such as cancer, but doctors will help a person work around the condition.

A doctor will regularly check a person’s white blood cell count if they have a condition known to cause leukopenia.

Getting regular blood tests helps leukopenia to be identified early and treated before it leads to complications.

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