Your blood is made up different types of blood cells, including white blood cells, or leukocytes. White blood cells are an important part of your immune system, helping your body to fight off diseases and infections. If you have too few white blood cells, you have a condition known as leukopenia.
There are several different types of leukopenia, depending on which type of white blood cell your blood is low in:
Each type protects your body from different kinds of infections.
If your blood is low in neutrophils, you have a type of leukopenia known as neutropenia. Neutrophils are the white blood cells that protect you from fungal and bacterial infections. Leukopenia is so often caused from a decrease in neutrophils that some people use the terms “leukopenia” and “neutropenia” interchangeably.
Another common type of leukopenia is lymphocytopenia, which is when you have too few lymphocytes. Lymphocytes are the white blood cells that protect you from viral infections.
Symptoms of leukopenia
You probably won’t notice any signs of leukopenia. But if your white cell counts are very low, you may have signs of infection, including:
- fever higher than 100.5˚F (38˚C)
Ask your doctor what to watch for. If you have any symptoms, tell your doctor right away.
Causes of leukopenia
Many diseases and conditions can cause leukopenia, such as:
Blood cell or bone marrow conditions
- aplastic anemia
- hypersplenism, or overactive spleen
- myelodysplastic syndromes
- myeloproliferative syndrome
Cancer and treatments for cancer
Different types of cancer, including leukemia, can lead to leukopenia. Cancer treatments can also cause leukopenia, including:
- radiation therapy (especially when used on large bones, such as those in your legs and pelvis)
- bone marrow transplant
Congenital disorders are present at birth. Congenital problems that can lead to leukopenia include conditions that affect how bone marrow works to make blood cells, such as:
- Kostmann syndrome, or severe congenital neutropenia
Infectious diseases that can cause leukopenia include:
Autoimmune disorders that kill white blood cells or bone marrow cells, which make blood cells, can also lead to leukopenia. These include:
Leukopenia can be caused by vitamin or mineral deficiencies, such as deficiencies in:
Medications that can cause leukopenia include:
- bupropion (Wellbutrin)
- clozapine (Clozaril)
- cyclosporine (Sandimmune)
- lamotrigine (Lamictal)
- minocycline (Minocin)
- mycophenolate mofetil (CellCept)
- sirolimus (Rapamune)
- sodium valproate
- tacrolimus (Prograf)
Sarcoidosis is a systemic illness caused by an exaggerated immune response and characterized by formation of granulomas, or small areas of inflammation, in multiple systems in your body. When these granulomas form in your bone marrow, leukopenia can result.
Viral infections that affect the bone marrow or other severe infections can also lead to leukopenia.
Who is at risk
Anyone who has a condition that can cause leukopenia is at risk. Leukopenia usually doesn’t lead to noticeable symptoms. So your doctor will monitor your blood cell counts carefully if you have any of the conditions that can lead to it. This means undergoing frequent blood tests.
Having a low white blood cell count can help point your doctor to the cause of your illness.
Usually, your doctor will learn that your white blood cell counts are low after ordering a blood test like a complete blood count to check on a different condition.
Treatment for leukopenia depends on which type of white blood cell is low and what’s causing it. You may need other treatments to take care of any infections that develop from not having enough white blood cells. Common treatments include:
Medications can be used to stimulate your body to make more blood cells. Or you may be prescribed medications to clear up the cause of the reduced cell count, such as antifungals to treat fungal infections or antibiotics to treat bacterial infections.
Stopping treatments that cause leukopenia
Sometimes you may need to stop a treatment like chemotherapy to give your body time to make more blood cells. Your blood cell counts may naturally rise when treatment like radiation is over or between chemotherapy sessions. Keep in mind that the amount of time it takes for white blood cells to replenish varies from person to person.
Granulocyte colony-stimulating factor and other growth factors derived from bone marrow can help if the cause of your leukopenia is genetic or caused by chemotherapy. These growth factors are proteins that stimulate your body to produce white blood cells.
An immunocompromised diet, also called a low-bacterial diet or neutropenic diet, may be recommended if white blood cells are very low. This diet is thought to reduce your chances of getting germs from food or because of the way food is prepared.
Your doctor will also talk about how you can take care of yourself at home when your white blood cells are low. For instance, try these tips to feel better and avoid infections:
Eat well: To heal, your body needs vitamins and nutrients. Unless your doctor tells you otherwise, eat plenty of fruits and vegetables. If you have mouth sores or nausea, experiment to find foods you can eat and ask your doctor for help.
Rest: Try to plan the activities you must do for the times you have the most energy. Try to remember to take breaks and ask others for help as part of your treatment.
Be very careful: You want to do all you can to avoid even the tiniest of cuts or scrapes because any open place in your skin provides a place for an infection to start. Ask someone else to cut food while you cook or eat. Use an electric razor to avoid nicks if you need to shave. Brush your teeth gently to avoid irritating your gums.
Keep away from germs: Wash your hands throughout the day or use hand sanitizer. Stay away from sick people and crowds. Don’t change diapers or clean any litter boxes, animal cages, or even a fish bowl.
If you have a condition that increases your chances of developing leukopenia, your doctor will routinely check your white blood cell count to help prevent or lower your chance of developing complications.
Here’s one reason it’s important to follow up on your blood tests: When you’re sick, many of your symptoms are caused from the actions of your immune system — including your white blood cells — as they try to kill the infection. So if your white blood cells are low, you could have an infection but not have symptoms that would prompt you to see your doctor.
Some of the most serious complications of leukopenia include:
- needing to delay cancer treatment because of even a mild infection
- life-threatening infections, including septicemia, which is a body-wide infection
You can’t prevent leukopenia, but can you can take actions to prevent infections when your white blood cell count is low. That’s why your treatment will include eating well, resting, and avoiding injuries and germs. If you have trouble doing any of these, talk with your doctor, nurse, or a dietitian. They might be able to adapt some of the guidelines to work better for you.