Leukopenia: Causes & Treatment

Leukopenia is a condition in which you have a lower-than-normal number of white blood cells (leukocytes) in your blood. It is also called neutropenia when you have a low neutrophil count, a type of white blood cell.

White blood cells are made in the bone marrow and are a part of the body’s immune system. They help our body fight infections and diseases. Having a low white blood cell count (leukopenia) puts you at an increased risk of infections. There are various conditions that can be responsible for causing leukopenia. Please continue reading to learn about the possible causes of leukopenia and treatment options.

What is the normal white blood cell count?

The normal amount of white blood cells (WBCs) is 4,500 to 11,000 per microliter of blood (4.5 to 11.0 × 10⁹/L). A total WBC count of less than 4,000 per microliter is called leukopenia. Leukopenia can be detected with a blood test called a complete blood count (CBC), which measures many different parts of the blood, including white blood cells, red blood cells, and platelets. Doctors can even measure different types of white blood cells, for example, the number of neutrophils with an absolute neutrophil count.

What’s the difference between leukopenia and leukemia?

As mentioned, leukopenia is a low white blood cell count (WBC count). Leukemia is a type of myeloproliferative syndrome (blood cancer) in which abnormal blood cells grow out of control and outnumber healthy blood cells. People with leukemia can develop leukopenia due to low blood counts of healthy white blood cells.

What causes leukopenia?

Various conditions can cause leukopenia (low white blood cell counts), such as:

Cancer treatments, including chemotherapy drugs and radiation therapy
Bone marrow disorders such as aplastic anemia and multiple myeloma
Autoimmune disorders such as lupus (SLE), rheumatoid arthritis, and Crohn’s disease
Congenital disorders such as Kostmann syndrome
Chronic idiopathic neutropenia (a low neutrophil count without any clear cause)
Disorders of the liver or spleen, such as an overactive spleen
Viral illnesses such as mononucleosis (mono), Epstein-Barr virus, hepatitis, and HIV
Severe bacterial infections such as sepsis (a bloodstream infection) and tuberculosis
Infectious diseases such as malaria
Malnutrition (due to vitamin and mineral deficiencies)
Severe physical stress due to injury or surgery
Severe emotional stress
African-American ethnicity
Side effects of certain medications, such as antibiotics

What are the symptoms of leukopenia?

Leukopenia itself does not cause any symptoms. However, when you have low white blood cell counts, you are at an increased risk of infectious diseases because white blood cells fight infection. These infections can cause symptoms such as fever, chills, sore throat, white patches in the mouth, mouth sores, cough, shortness of breath, diarrhea, painful urination, pus in wounds, and unusual vaginal discharge or itching.

What is the best treatment for leukopenia?

Treatment for leukopenia depends entirely on the underlying cause. For example, if you have an infection, your healthcare providers may prescribe antibiotics for bacterial infections, antiviral drugs for viral illnesses, or antifungal medicines for fungal infections. Other treatments may consist of anti-inflammatory drugs, corticosteroids, pain relievers, and immunosuppressant medications for autoimmune diseases.

If there is a deficiency in your bone marrow, healthcare providers may use growth factors to help your bone marrow make more blood cells. For example, a granulocyte colony-stimulating factor such as filgrastim (Neupogen, Zarxio, Nivestim, Granix) is used to treat neutropenia and prevent infections. It is also used to prepare the blood before collecting certain types of blood cells. Additionally, granulocyte colony-stimulating factor is used in patients who have undergone cancer treatment as well as those with severe neutropenia that is unrelated to cancer treatments. It is also used before a bone marrow transplant or autologous stem cell transplant.

Is leukopenia always serious?

For understanding blood counts and blood basics, it is important to remember that normal levels of white blood cells can vary with age, sex, and ethnicity. Some people can still be healthy even if their lab test results show low WBC counts. Only a medical professional can decide if your leukopenia is serious. Your healthcare provider will perform a physical exam and order various tests to rule out serious underlying conditions, such as infections, autoimmune conditions, or cancer. If any medical conditions are found, they will develop a treatment plan accordingly.

When should I be worried about leukopenia?

Leukopenia increases your risk of infection. Call your healthcare provider if you develop recurrent or severe infections. There is nothing you can do to prevent leukopenia. But if you have an underlying condition that causes leukopenia, you should practice good personal hygiene and take other measures to avoid infection, such as avoiding contact with people who are sick.

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