What is leukopenia?
Leukopenia is a condition in which abnormally low white blood cells are circulating in the blood. This condition can be diagnosed using a blood test called complete blood count (CBC). A normal white blood cell count is usually between 3,500-11,000 WBCs per microliter. People with leukopenia typically have less than 3,500 WBCs per microliter.
Most white blood cells are produced in the bone marrow and are very important for the body's immune system. A reduction in WBCs means that the body won't probably be able to fight off diseases and other types of infection.
The different types of leukopenia usually depend on the following types of white blood cell reduced in the blood:
- Neutrophils - are 55-70 percent of the total white blood cells. Neutrophils fight off bacterial and fungal infections.
- Lymphocytes - are white blood cells that usually fight off viral infections.
- Monocytes - are the largest among WBCs. Aside from fighting off harmful microorganisms, monocytes also aid in the repair of damaged tissues due to inflammation.
- Basophils - are the least common type of WBCs, which involve inflammatory responses to allergens.
- Eosinophils - these WBCs play a role in allergic reactions, such as asthma, as well as fight off parasitic infections.
Each type of WBC protects the body from various infections. The common types of leukopenia are neutropenia (low neutrophils in the blood) and lymphocytopenia (too few lymphocytes in the blood). In most cases, leukopenia is caused by neutropenia, which is why some people interchangeably use the terms leukopenia and neutropenia. Neutrophils are WBCs that provide protection against bacterial and fungal infections, while lymphocytes protect people from viral infections.
Having a low WBC count may show no symptoms. However, when a person has leukopenia, he or she is more prone to developing infections, and experience the following symptoms:
The symptoms of leukopenia are related to the main cause of low WBC count. The causes of leukopenia may include:
- Viral Infections: Leukopenia may be temporarily experienced in acute viral infections, such as the common cold or the flu. Viral infections may disturb the normal WBC production in the bone marrow.
- Blood Cell and Bone Marrow Conditions: These conditions can lead to leukopenia. Some examples include aplastic anemia, overactive spleen, myelodysplastic syndromes, myeloproliferative syndrome, and myelofibrosis.
- Infectious Diseases: In a study conducted in 2015, women infected with tuberculosis (TB) are more prone to developing leukopenia than men. Aside from tuberculosis, HIV infection and AIDS can also lead to leukopenia.
- Autoimmune Disorders: Rheumatoid arthritis and lupus are types of autoimmune disorders that can kill white blood cells.
- Congenital Disorders: Severe congenital neutropenia or Kostmann disease and myelokathexis are congenital disorders that cause leukopenia.
- Malnutrition: Leukopenia can also be due to certain vitamin and mineral deficiencies, such as a deficiency in folate, vitamin B12, zinc, and copper.
- Sarcoidosis: This systemic illness is due to the immune system's exaggerated response, and causes inflammation in small areas of the body. The bone marrow can also be affected and result in leukopenia.
Other causes of leukopenia may include certain treatments, which include:
The following medications may also lead to leukopenia:
- Minocycline (a tetracycline antibiotic)
- Immunosuppressant drugs such as cyclosporine, mycophenolate mofetil, sirolimus, and tacrolimus
- Interferons for multiple sclerosis treatment
- Clozapine for psychiatric disorders
- Bupropion to quit smoking and as an antidepressant
- Sodium valproate and lamotrigine as mood stabilizers or for epilepsy
Treatment for Leukopenia
Treating leukopenia usually depends on what is causing it and the type of white blood cell affected. Other treatments may be required to resolve certain infections caused by having a low white blood cell count. The common treatments include:
To stimulate the body to produce more blood cells, certain medications can be used. Treating the cause of the reduced white blood cell count is also an effective approach to resolving leukopenia. It may include treating fungal infections using antifungals, and treating bacterial infections by using antibiotics.
Discontinuing treatments that lead to leukopenia
The body must be given time to produce more blood cells, especially when it undergoes treatment like chemotherapy. Blood cell counts usually increase after chemotherapy or radiation treatments are done. However, the time it takes for WBCs to increase their number still vary from one patient to another.
The body makes proteins called growth factors. Some of these growth factors make the bone marrow to produce blood cells. A type of growth factor called granulocyte colony stimulating factor (G-CSF) makes the bone marrow to produce WBCs to minimize the risk of developing infections after cancer treatment.
Patients with cancer may have G-CSF after undergoing chemotherapy to help recover lost white blood cells. Patients can also have it before or after a bone marrow transplant.
When white blood cells are very low, a neutropenic diet may be recommended. This type of diet is also called low-bacterial diet or the immunocompromised diet since it is meant for people who have weakened immune systems. This diet may help protect immunocompromised patients against harmful microorganisms present in certain types of food and drinks.
Treating Leukopenia at Home
When your WBCs are low, the doctor may speak to you about how to properly take care of yourself at home. Below are some tips that can help you feel better and prevent infections:
- Rest: Certain activities must be planned, so you will have enough time to prepare and recharge your body. Also, remember to have breaks in between activities. You can ask others to accompany or assist you as well.
- Eat well: Vitamins and other nutrients are needed by the body to effectively recover. You can eat fresh fruits and vegetables instead of highly processed foods.
- Prevent cuts and scrapes: An open wound is also an open invitation to infections. To avoid getting cuts or scrapes, you can ask someone to cut food while cooking or eating. If you need to shave, use an electric razor to avoid nicks. Gently brush your teeth to avoid gum irritation.
- Stay away from germs: Avoid huge crowds and stay away from people who are sick. Maintain good hygiene by washing your hands with soap and water after using the toilet, coughing or sneezing, cleaning litter boxes, and changing diapers.