Leukopenia is a disorder where a person has a reduced number of white blood cells and as a result, there is an increased risk of infections.
There are 3 types of blood cells in the blood, red blood cells are also called erythrocytes or red blood cells that carry oxygen to cells and tissues; platelets are small cells that help the blood to clot; white blood cells, the body soldiers, that fight infection, and repair tissue. leukocytes have the special ability to mount an immune response to destroy germs, normal cells, and cancerous cells. 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. The diagnosis of leukopenia is commonly down through a complete blood cell count or CBC or a Leukogram. The normal white blood cell count in the blood is between 3,500 and 11,000 white blood cells. If the count is under 3500, the term leukopenia is used. If it is above 11,000, the term leukocytosis is used.
The bone marrow, which is the tissue that is inside the bone is responsible for producing white blood cells. As these, bone marrow immature white blood cells develop, they form 5 different types of white blood cells. Each of these types of cells has a special function and are the immunoprotective army that is available and ready in our system.
White blood cells are the general term for the 5 types of white blood cells: Neutrophils, lymphocytes, eosinophils, basophils, monocytes.
Neutrophils: These make up 50-70% of total white blood cells. They help fight off fungal and bacterial infections. They are also involved in the healing processes
- Lymphocytes: These are the second most common type of white blood cell. They protect the body from viral infections and cancer cells
- 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 repair tissue that has been damaged by inflammation. They are also important finding tumor cells
- Eosinophils: These fight parasites and play a role in allergic reactions and conditions, such as asthma and eczema.
How is a leukopenia diagnosed?
Like most blood disorders, a thorough physical examination and medical history are essential.
–Complete blood cell count (CBC) with differential: A sample of blood is drawn and analyzed for the number of red blood cells and platelets, number and type of white blood cells, amount of hemoglobin and the red blood cells, and the portion of the blood sample made up of red blood cells. In addition, from this CBC a peripheral blood smear is made to study the morphology of the red blood cells, the number, and types of white blood cells, and normal platelets, on addition; check for the presence of blast cells.
–Blood chemistry studies: In this procedure blood sample is taken to measure the amount of certain substances released into the blood by organs and tissues in the body.
–Bone marrow aspiration and biopsy: in this procedure, a hollow needle is inserted In the hip or breast bone, and bone marrow, blood and a small piece of bone are removed. These are examined by a pathologist under a microscope to look for abnormal cells,
The same sample it is normally used for flow cytometry, fluorescent in situ hybridization, cytogenetics, and gene mutation test; the mutations currently tests are Philadelphia chromosome, Jak 2, MPL, and CALR.
What are the symptoms of Leukopenia?
Leukopenia normally indicates an underlying medical condition. However, the common symptoms of low white blood cell count or leukopenia may include:
- Fever and chills
- Body aches
- Muscle pain
- Leukopenia can be found together with low platelets or liver disorders.
Causes of Leukopenia
1. Congenital Disorders
2. Viral Infections
3. Bone Marrow Diseases, Damage, or Suppression like Leukemia, Myelofibrosis, Folate deficiency or vitamin B12 deficiency, Myeloproliferative disorders, Myelodysplastic syndrome, aplastic anemia. Exposure to certain toxins, chemicals, radiation, chemotherapy, and certain drugs may damage or suppress the bone marrow. When there is damage to the bone marrow, blood cells are less produced, which then leads to anemia and leukopenia. For the bone marrow to properly function, certain essential nutrients are required.
4. Cancer and complications of cancer
6. Overwhelming Infections like sepsis
7. Drugs: Medications such as clozapine, lamotrigine, sodium valproate, interferons, sirolimus, tacrolimus, cyclosporine, mycophenolate mofetil, minocycline, penicillin,
8. Autoimmune Disorders/Diseases of the Immune System: lupus, rheumatoid arthritis, and thyroiditis
9. Anorexia Nervosa
- Parasitic infections
- Typhoid fever
- Rickettsial infections
- Deficiency of minerals such as copper and zinc
How is Leukopenia treated?
Treatment for Leukopenia is directed at alleviating symptoms and targeting the infections and treating them at the earliest. Treatment for leukopenia is usually palliative. Some of the methods of treating Leukopenia are:
- Vitamins and Steroids. These are given to patients to try to increase the white blood cell count, as they are useful in stimulating the bone marrow to produce more white blood cells and treat Leukopenia.
- If cancer is a cause for the patient’s Leukopenia then chemotherapy may be done to treat the cancer and then medications may be given to treat Leukopenia
- Using medications that stimulate the bone marrow to produce white blood cells is a mainstay of leukopenia treatment. The two most widely used so-called growth factors are Neupogen and Neulasta. These drugs are given as an injection and are effective in increasing WBC levels. However, they should be used with great caution in patients with sickle cell disorder, abnormalities in red blood cells, myelodysplasia and chronic myeloid leukemia. When using WBC growth factors, prompt medical care should be sought for symptoms of sudden abdominal pain, shortness of breath or signs of infection. Steroids may be used for immune-mediated leukopenia and function by redistributing existing white blood cells so they can be better utilized.
The information in this document does not replace a medical consultation. It is for personal guidance use only. We recommend that patients ask their doctors about what tests or types of treatments are needed for their type and stage of the disease.
American Cancer Society
The National Cancer Institute
National Comprehensive Cancer Network
American Academy of Gastroenterology
National Institute of Health
MD Anderson Cancer Center
Memorial Sloan Kettering Cancer Center
American Academy of Hematology