White blood cells help to protect your body from infection. Most of the time you will hear about neutrophils (New-troh-fils). The body protects itself against the constant threat of infection by making a lot of neutrophils.

If your neutrophil count (the number of neutrophils in your blood) is low, there is a greater chance you might develop an infection. Neutropenia is a word used to describe a low neutrophil count. Immunosuppression is another term used when white blood cells are low.

Impact of Chemotherapy

Most cancer cells grow and divide very quickly. Chemotherapy drugs work by acting quickly on dividing cells. Unfortunately, chemotherapy drugs can’t tell the difference between cancer cells and normal cells that also divide quickly. Blood cells such as red blood cells, white blood cells (neutrophils), and platelets all divide quickly and are also killed by chemotherapy drugs. However, the decrease in your blood cell count with chemotherapy is only temporary.

Blood Test Monitoring

Blood tests are taken regularly to monitor your white blood cell counts (neutrophils).

• Normal white blood cell (WBC) levels: 4 - 11
• Normal absolute neutrophil count (ANC): 2 - 6
• If your ANC is below 1 you have a greater chance of getting an infection.
• An ANC of 0.5 or less means even greater care will have to be taken to decrease your risk of infection.
• If your ANC is very low, your cancer treatment may be postponed until a later date.

Signs and Symptoms of an Infection

• Sore throat Eye/ear discharge Chills (shaking)
• Nasal congestion Break in skin Loose stools
• Burning at anus Pain Redness
• Urinary burning Cough Swelling
• Sweating Fever (>38°C)

Suggestions to help you decrease your risk of infection

Modifying your lifestyle:

• Wash hands
• Maintain good body hygiene
• Use liquid rather than bar soap
• Bath every day, gently pat skin dry; use moisturizer to prevent dry skin
• Use cuticle cream remover rather than picking or cutting nail cuticles
• Use deodorant rather than antiperspirant
• After a bowel movement, clean rectal area thoroughly
• Do mouth care frequently, carefully, yet thoroughly
• Try ½ tsp. of baking soda and ½ tsp. of salt in an 8 ounce glass of water instead of mouthwash
• Use a clean electric razor rather than a straight or twin blade safety razor
• Avoid taking rectal temperatures, or using rectal or vaginal suppositories (women use napkins, not tampons)
• Use a lubricant during intercourse; use a condom if engaging in anal intercourse
• Protect yourself from burns, cuts, and scratches
• Avoid contact with any potentials for infection (stagnant water, people with colds, open sores, enclosed public areas with crowds, animal excreta, etc.)
• Avoid vaccinations, and those people recently vaccinated with live vaccine (ie. infants 12-15 months old)
• Exercise a bit each day

Diet

• Eat well balanced meals. Dietitians are available to assist you in planning.
• Drink 2-3 litres (8-12 glasses) of liquid a day unless you have a heart or kidney problem.

Summary

• If you should develop an infection while your white count is low, antibiotics by an intravenous infusion (IV) will most likely be given.
• Gradually resume normal activities as you recover from chemotherapy.
• If you have any further concerns or questions that you are unsure of, please ask your doctor or nurse for help.

Call your doctor if

• You experience any of the signs of infection
• You have a fever >38°C
  
  

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