Neutropenia

Neutropenia is a low level of neutrophils, the white blood cells that fight bacterial infection. It is a common side effect of chemotherapy, including the platinum and pemetrexed drugs used for mesothelioma, and a frequent reason a chemotherapy dose is delayed or reduced. A fever during neutropenia is a medical emergency.

Origin

The word comes from neutrophil, named for the way these cells take up neutral stains under the microscope, and the Greek penia, lack. Doctors measure it as the absolute neutrophil count (ANC) on a routine blood test; below 1,500 cells per microliter is usually called neutropenia, and below 500 is severe.

Significance in Asbestos Context

Chemotherapy kills fast-dividing cells, including the bone marrow cells that make neutrophils, so counts typically fall to their lowest point one to two weeks after a dose and then recover. Pemetrexed's effects on the blood are reduced by folic acid and vitamin B12 supplements, which is why patients take them. When the count is too low on treatment day, the dose is usually delayed or lowered, and doctors may prescribe growth-factor injections (such as filgrastim or pegfilgrastim) to speed recovery. Febrile neutropenia, a fever of about 100.4°F (38°C) or higher with a low count, can mean a fast-moving infection and needs same-day emergency care, often with hospital admission and intravenous antibiotics. For families, this explains sudden schedule changes and why a thermometer matters at home. In a claim, hospital stays for neutropenic fever and growth-factor treatment are part of the medical costs and suffering caused by the disease.

Example Sentence

Her second cycle of cisplatin and pemetrexed was postponed a week because her blood test showed neutropenia, with an absolute neutrophil count of 900.

Related Terms

Chemotherapy, Platinum-Pemetrexed, Pemetrexed (Alimta), Cisplatin, Economic Damages, Quality of Life, Palliative Care

Notes

• Keep a working thermometer at home during chemotherapy, and know the temperature at which your team wants a call.
• Ask your oncology team whom to call after hours.
• Keep blood count results and records of any hospital admissions.