Hanging Chemo

At our clinic the nurse can start chemotherapy on a patient with an ANC of 1500 without contacting the physician, lower than 1500 ANC or plt count below 100 we call.

We usually give chemo with ANC of 1.5 or above. Often times we will treat with a lower ANC with filgrastim or pegfilgrastim support. It also depends on the patient's regimen. If you are a member of ONS, there is a great online lecture through their web site that discusses ANC, GSF support, and discusses high-risk vs. lower risk patients.

What is the normal range for ANC that you can start chemotherapy?

It depends on the chemo. Most of the time, you need to call and verify with the MD, if the ANC is less than 1500.

Of course with some cancers, such as AML, check the notes as to whether the MD already knows. Because with many leukemias you will probably be giving the chemo, no matter what the ANC is.

An ANC Below 500 means the patient has reached their Neutropenic level and is on isolation "Reverse isolation" ...Their anc drops as a result to chemo though usually unless they are leukemic..