What is Neutropenia?

    Let’s start by explaining what a ‘neutrophil’ is. Neutrophils are an essential part of our immune system that,“ingest, kill, and digest invading microorganisms, including fungi and bacteria.” according to the NIH, National Institute of Health [Link for reference here]. 

   Neutrophils are our most common white blood cell. They protect against viral infections, fungal infections and bacteria.

Why would these be low for a childhood cancer patient?

   Neutrophils are destroyed as a side effect because of many of today’s options for chemotherapy and radiation children and adolescents receive. When they are low, this is called ‘Neutropenia’. Childhood cancer patients can also be said to have an ‘immunodeficiency’, when this occurs, which refers to a state where the immune system is weakened or impaired, making the body more susceptible to disease.

How do you know if they are low?

Neutrophils are tested for during a complete white blood count, or CBC. For childhood cancer patients this is a frequent, recurring test, even more so when these are suspected to be low! This means a lot of ‘pokes’ for a childhood cancer patient to monitor their blood counts for this condition called Neutropenia.

Why is Neutropenia such a big problem for those with childhood cancer?

Neutropenia provides an avenue for what is called ‘opportunistic infections’. Serious infections may occur when a child or adolescent undergoing cancer treatment is ‘neutropenic’(the word used to describe having neutropenia) or immunocompromised (aka: weakened immune system). This may cause repeated admissions for additional care, including blood transfusions, antibiotics, antifungals and other supportive measures are often necessary when these opportunistic infections threaten childhood cancer patients’ lives.

  “A patient with severe neutropenia is considered to have a life threatening disorder, and should be monitored regularly.” [Link for reference here provided by the NIH]. 

 

What kind of infections are children and adolescents susceptible to while neutropenic?

Neutrophils protect against viral infections, fungal infections and bacterial infections.

 These viruses, fungi and bacteria live in all of our bodies as well…children undergoing cancer treatment don’t even have to be exposed, but exposure is always a bad thing.

 Neutropenic children can develop illness or an infection from these viruses, fungi and bacteria that live in our daily environments, while people with enough neutrophils are protected from these.

Even the best intentioned children have some pretty gross habits…(Even some adults!), now imagine destroying the ability to fight off what is often seen as a benign infection- colds, sore throats, skin rashes….this is now amplified in a childhood cancer patient whose system is immunocompromised and neutropenic and can cause recurrent infections.

 Lacking the army of neutrophils to protect them, a higher risk of getting sick is a very real threat.

Is Neutropenia always so serious?

   Each level of neutropenia carries its own added risk of infection. (show a chart here that escalates) It can be mild, moderate or severe but, good to note, that with children undergoing childhood cancer treatment these situations can escalate quickly, and is the reason for frequent blood draws and monitoring.

Can anything be done to help prevent Neutropenia?

   Many childhood cancer patients are given  neutrophil colony-stimulating factors, often called G-CSF/GCSF, in the form of an injection, either daily or after certain chemotherapy regimes to help stimulate their bone marrow to produce an increased number of white blood cells, neutrophils. These are given after certain chemo infusions because of the severity of this disorder that is produced as a result of current treatment options. These injections themselves come with additional side effects including bone pain, often debilitating, and pain or bruising at the injection site.

     Stay tuned to Elevate’s Building Bridges Blog for more on these types of injections as we hear directly from childhood cancer families who have more to share on their experiences with Neutropenia and how it impacted their children undergoing treatment.

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