LOW WHITE BLOOD CELLS
White Blood Cells:
There are three main types of cells in your blood: white cells, red cells and platelets. White blood cells help your body to fight infections. When there are not enough white blood cells in the blood, you may be at risk of getting an infection more easily, or you may be at risk of having a more difficult time in fighting off an infection. You should take special precautions to avoid infections when your white blood cell count is low.
How to know if your white blood cells are low:
To confirm if your white blood cells are low, a blood sample will be taken and the lab will count the number of white blood cells. This is called a white blood cell count or WBC. The WBC count is normally 4.0 (X109 /L) or higher, but it may drop as low as 1.0 (X109 /L) to 2.0 (X109 /L) during chemotherapy, without causing serious harm.
There are some signs of infection which might occur when your white blood cells are low, such as:
- Fever (temperature over 100o F or 38o C). Keep a thermometer at home and check your temperature daily while you are receiving chemotherapy treatments.
- Chills or shaking.
- Unusual sweating.
- Burning feeling when passing urine. More frequent urination.
- Redness, heat, swelling and drainage from a wound.
- Cough with yellow or green coloured sputum.
- Sore throat (along with fever).
- Diarrhea (along with fever).
What should you do if you notice any of these symptoms:
If you have an infection when your white blood cells are low, this is a medical emergency. Even if you feel reasonably well, you must contact your doctor or nurse or go the emergency department IMMEDIATELY!
Your nurse, doctor, or pharmacist will tell you when to expect low white blood cell counts. This will help you to know when to watch for any of the signs of infection. You may need medications that help rebuild the supply of white blood cells to correct the low count.
What you should do:
- Take your temperature by mouth daily while on treatment, when WBC counts are likely to be low, and especially if you are feeling unwell with chills, sweats or a fever. If your temperature is at or above 100oF or 38oC, call your doctor or nurse or go to the emergency department IMMEDIATELY.
- Stay away from people who have colds, flu or other contagious diseases. If your white blood cells are low, you should avoid crowds of people in public places, such as shopping malls.
- Eat a well-balanced diet.
- Wash all fruits and vegetables. Avoid raw meat and raw fish. • Drink at least 8 glasses of fluid a day.
- Wash your hands often with soap and water, especially before eating and after using the toilet. Keep your hands away from your mouth.
- It is important to keep your mouth clean and moist. See the pamphlet Mouth Care for more information on rinsing and brushing.
- Check with your doctor before you have any dental check-ups or dental procedures. • Shower or bathe daily, if you are able.
- Prevent constipation. If you need a laxative, ask your doctor, nurse or pharmacist for help. Avoid rectal suppositories or enemas when your white blood cells are low. See the pamphlet Constipation for more information.
- Scrapes or cuts on the skin should be cleaned immediately with soap and warm water.
What you should not do:
- Do not touch animal ‘droppings’, litter boxes or birdcages. (If you must clean up after an animal, use rubber gloves.)
- Do not work in the garden or with soil unless you are wearing gloves.
- Do not share drinking glasses or eating utensils.
- Do not forget that some medications (such as steroid agents and acetaminophen) can ‘hide’ an infection by reducing fever. Be aware of any signs of infection when taking these medications along with chemotherapy. Also, inform your doctor and pharmacist about all other medications you are taking.
- Do not have any vaccinations unless you check with your doctor.
Prepared by the Hamilton Regional Cancer Centre- Patient Education Committee, in cooperation with the staff and patients at HRCC and other Cancer Centres; Revised by the Cancer Care Ontario-Professional Pharmacy Advisory Committee- Medication Information Sheets Working Group. Any comments about the contents of this sheet, please email firstname.lastname@example.org Revised: March, 2006