Chemo and WBC Question

absolute neutrophil count is probably one of the more important parameters (normal being > 1500 cells per cubic milliliter) that can dictate whether you give a dose of chemo or not. the obvious risk for neutropenia is infection. as to whether to give the dose or not is dependent on each individual case.

in my general experience, one usually holds a dose of chemo if there is a moderate to severe neutropenia. but i've also seen some oncologists hold doses for even a mild drop and others give the dose regardless of a severe drop; especially if it's considered a last ditch attempt at life saving.

thus, there are no strict iron clad parameters, per se: the general guideline is to understand the risks involved with mild, moderate, or severe neutropenia. the clinician will then have to weigh that risk versus the perceived benefit.

anc = (%neutrophils + %bands) x wbc

see this page for how to calculate: http://www.globalrph.com/anc.htm

*** sidebar *** neutrophils can go by a variety of names: aka polymorphonuclear cells, pmn's, polys, granulocytes, segmented neutrophils or segs.

Most often, our docs write these parameters for SOLID TUMORS AND LYMPHOMAS ONLY: WBC less than or equal to 3, ANC less than or equal to 1500, hemoglobin less than or equal to 10, platelets less than or equal to 100,000, or creatinine greater than or equal to 1.5.

Please know that patients with leukemia get chemo despite their labs because there are often so neutropenic and anemic because of their disease process.

It depends on the cancer, the MD and the chemo. All are quite variable.

I work with leukemics, ours almost always get chemo no matter what the ANC. However, if it is very high we may have to take extra precautions against tumor lysis.

I've only really given chemo for leukemia, very aggressive lymphoma, and BMT conditioning. I've never seen a chemo dose held because of blood counts. We typically transfuse for low hgbs or plts (