Neutropenia

A patient who is suffering from neutropenia has a weakened immune system. The Absolute Neutrophil Count (ANC) is a blood test used to determine if a patient is neutropenic. A normal ANC is 2,500 to 5,000 cells/mm³; however, people with neutropenia often have an ANC from 0 to 1,000 cells/mm³. For a patient with an ANC of 500 cells/mm³, a special diet is often required.

Neutrophil are the most abundant type of white blood cells in a healthy individual. These cells are the first cells to try to fight off infections in the body. In a person who has AIDS, cancer and other diseases that affect the immune system, the ANC level decreases. Other people who are affected by decreased ANC levels are those who have had a stem cell transplant, those who have had organ transplants, and those who are going through chemotherapy or radiation treatments.

Because the ANC level can vary from one day to another, patients who are at risk of a decreased ANC level have the ANC test done often, sometimes as often as once per day.

What is the Significance of a Diagnosis of Neutropenia?

From the time that a patient is diagnosed with neutropenia until the ANC counts rise to a normal level, the patient must be extremely careful to avoid any circumstances where she may be introduced to bacterium or other disease spreading organisms. This requirement can affect every aspect of the patient's life.

Frequent hand washing is a must for the neutropenic and anyone who touches her or the surfaces she touches. She must wear a mask in public, or may not be allowed to go out into public if the ANC level is extremely low. In some cases, special disposable gowns must be worn by the patient and anyone who will come into contact with her.

She must also make sure that all foods are thoroughly cooked and that all dishes, utensils and food preparation surfaces have been thoroughly cleaned. Eating out isn't usually possible because of the risk of germs on the utensils, dishes and food prep surfaces.

Even the foods the person eats are severely restricted. The patient must follow a neutropenic diet. Fresh fruits and vegetables, which are normally part of a healthy diet, must be avoided. Leftovers must be consumed within 24 hours or they have to be thrown out. Raw nuts, homemade ice cream, and pastries that have a cream filling must also be avoided.

A person who has neutropenia must avoid having intercourse.

Conclusion

Living a neutropenic lifestyle is a big adjustment for the patient and her family. However, the need to follow the neutropenic guidelines is often temporary, as ANC counts will usually begin to rise to a suitable level where a normal lifestyle can be safely resumed.

Sources:
http://www.oncolink.org/coping/article.cfm?c=5&s=22&ss=175&id=970
http://www.upmc.com/HealthAtoZ/patienteducation/Documents/NeutropenicDiet.pdf