Blood Counts
Blood Counts During Chemotherapy
Blood counts are checked frequently while receiving chemotherapy. This close monitoring should help keep severe problems from occurring.
There are 3 important types of cells produced in the bone marrow and checked in our blood count. They are:
- Red blood cell (RBC’s)
- White blood cells (WBC’s)
- Platelets
Red Blood Cells (RBC’s)
Red blood cells contain hemoglobin. The hemoglobin combines with oxygen and carries the oxygen to the organs of the body. The hematocrit is the percentage of blood made up of the red blood cells. When the hemoglobin and hematocrit are low you are said to be anemic.
What are the signs of Anemia?
You may notice your child tires easily and looks pale when the hemoglobin is low.
Normal values:
- Hemoglobin:
- Child 12 – 14
- Female 12 – 16
- Male 14 – 18
- Hematocrit:
- Female 36 – 47%
- Male 39 – 54%
White Blood Cells (WBC’s)
White blood cells fight infections. When white blood cell count is low, your child will be more likely to get sick for bacterial, opportunistic, and viral infections.
There are different kinds of white blood cells. It is the neutrophils that are most important in fighting dangerous bacterial infections. Other names for neutrophils are granulocytes or polys. When your absolute neutrophil count (ANC) is low, this can also be called neutropenia, and a bacterial infection is suspected, antibiotics are usually prescribed.
What is Neutropenia?
Neutropenia is when your white blood cells are low enough to make your child more susceptible to infection.
What is ANC?
The ANC (Absolute Neutrophil Count) is a calculation of the percentage of segmented (“polys” or “segs”) and banded (“bands” or “stabs”) white blood cells on the total white blood count. Chemotherapy and radiation can cause suppression of your bone marrow, preventing normal production of blood cells. The ANC is an indicator of bone marrow production and provides a way to calculate your infection fighting abilities.
To calculate: WBC x (segs + bands) = ANC
Example: WBC = 3200
Segs = 20% 3200 x (20% + 3%) =
Bands = 3% 3200 x 0.23 = 736
Parameters
ANC > 1500 Normal
ANC 1000 – 1400 Mild neutropenia (very minimal if any risk of infection)
ANC 500 – 999 Moderate neutropenia
ANC < 500 Severe neutropenia (ability to fight infection is very low)
What are platelets?
Platelets are cells in the blood that form clots. These clots help to prevent excessive bleeding. Chemotherapy may lower your platelet count.
Normal values 150,000 – 350,000
What is Thrombocytopenia?
Thrombocytopenia is a drop in the platelet count. This may lead to easy bleeding. If the platelets drop below 20,000 a platelet transfusion will be necessary.
What are the signs to look for?
Minor bleeding:
- fine red rash (petechiae)
- bruises
- bleeding gums
- nosebleeds
- dark black (“tarry”) stools
Serious bleeding:
- persistent headache
- blurred vision
- dizziness
- vomiting of blood
- bloody bowel movements
- blood in urine
- coughing up blood
What can I do to prevent bleeding when platelets are low?
- Avoid forceful nose blowing
- Avoid straining with bowel movements. Use stool softeners as prescribed.
- Use soft toothbrushes or foam sticks (toothettes). Do not floss.
- Maintain a safe environment to avoid potential accidents.
- Use caution to protect from physical injury.
- Avoid contact sports and strenuous exercise.
- Avoid activities such as bike riding, skateboarding, etc. that may cause injury.
If bleeding does happen while platelets count is low it may be hard to stop. Anytime bleeding occurs that is hard to control, you should apply pressure and call your doctor.
If you suspect that your child’s platelets are low, a platelet count should be done. When the platelet count drops below a certain level, the doctor may order a platelet transfusion.
*Information provided by Florida Hospital Cancer Institute
Last update Nov. 1, 2008