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Neutropenia
Risks Associated With Neutropenia

When your neutrophils are low, you have less ability to fight infections. Infections can make you very sick and may cause you to miss your next treatment or need a smaller dose of chemotherapy. Smaller doses or delayed doses can sometimes mean a less effective treatment.

Causes of Neutropenia

Certain kinds of cancer treatment such as chemotherapy and radiation can affect your body's ability to make neutrophils. Chemotherapy affects the neutrophil count usually beginning anywhere from 7-14 days after you receive your dose of chemotherapy. Neutropenia is the term used to describe your condition when your neutrophils have dropped very low. The term "nadir" is used to describe the lowest point that your blood cells drop to after you receive treatment. Your blood cells are expected to drop after treatment (some treatments cause a bigger drop than others). The nadir can occur anywhere from 7 to 14 days after you receive your chemotherapy but can vary based upon the type of chemotherapy you receive, or the dose that you receive. The cells will start to rise again and will need to recover before you start another treatment. It is very important to understand that not every patient that develops neutropenia will develop an infection. Many patients will develop neutropenia after their treatment and recover without any complication.

There are many factors that contribute to the development of neutropenia, including the dose of chemotherapy (a higher dose usually causes a lower neutrophil count), the type of chemotherapy (some chemotherapies cause a greater drop in your neutrophils than others) and whether or not you have other problems in addition to cancer, such as HIV infection, etc.

Special Populations
The population in the United States is aging. The incidence of cancer among the elderly is increasing as well. Many elderly patients can experience the same benefits from standard chemotherapy as younger patients. However, elderly patients are more susceptible to myelotoxicity. Myelotoxicity refers to damage to the bone marrow that can include a drop in red blood cells (anemia), white blood cells (leukopenia and/or neutropenia) and platelets (thrombocytopenia). Support with growth factors may give elderly patients the opportunity to receive standard chemotherapy.