What is leukopenia?

Medically reviewed by Emelia Arquilla, DO — Written by Lana Burgess and Sarah

Charmley — Updated on December 21, 2021

What is leukopenia? Chronic Leukopenia vs. neutropenia Symptoms

Causes Diagnosis Treatment Outlook Contacting a doctor
Summary

A person with leukopenia has a low number of white

blood cells, or leukocytes, in their blood. White blood
cells help fight infection in the body. A person with a low
white blood cell count is more likely to contract an
infection. Leukopenia usually involves a lack of
neutrophils, which are a type of white blood cell.

Medical practices can differ in how they define a low white blood cell
count.

This article explores the effects of leukopenia on a person’s body, what

causes leukopenia, and the treatment options available.
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What is leukopenia?
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The National Cancer Institute  notes that a person has leukopenia if they
have a reduced number of total white blood cells in their blood.

According to the Leukemia & Lymphoma Society, a healthy white blood

cell count is 5,000–10,000 white cells per microliter (µL) of blood for
males and children, and 3,500–11,000 white cells per µL for females.

White blood cells are made in the bone marrow and are critical for the
immune system. A person with too few leukocytes is more prone  to
infections and diseases.
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A person has five types of white blood cells. Each type helps protect the
body from a different kind of infection:

Percentage of total white blood cells in the

White blood cell type
body

Neutrophils 55–70%

Lymphocytes 20–40%
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Basophils 0.5–1%
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Monocytes 2–8%

Eosinophils 
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 There are five kinds of leukopenia. Each one corresponds to the type of
white blood cell that is affected.

A 2019 article  notes that leukopenia typically occurs due to a low

neutrophil count. When a person has low neutrophil levels, healthcare
professionals refer to it as neutropenia.

When leukopenia involves low lymphocyte levels, it is called

lymphocytopenia.

Chronic leukopenia
Leukopenia can be acute or chronic.

Healthcare professionals deem neutropenia to be chronic if a person has

a low neutrophil level on at least three occasions over 3 months .

A person may develop chronic leukopenia due to several reasons, such

as:

Inherited conditions: Also known as congenital disorders, these

may lead to  leukopenia. Examples include Kostmann syndrome
and myelokathexis.
Cancer: Leukemia cells can force out  the cells in the bone marrow
that make normal blood cells. This can lead to leukopenia.
Blood cell and bone marrow conditions: Examples include anemia,
overactive spleen, and myelodysplastic syndromes.
Autoimmune disorders: Examples include lupus and rheumatoid
arthritis.
Infectious diseases: Examples include HIV, AIDS, and tuberculosis.

A person who develops  an infection of the spleen can also experience

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chronic leukopenia.
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 Leukopenia vs. neutropenia
Leukopenia refers to a reduced number of total white blood cells. A
person with leukopenia can have a reduction in any type of white blood
cell.

Neutropenia is a type of leukopenia. A person with neutropenia has a low

neutrophil count. Neutrophils are the most common type of white blood
cell.

The American Cancer Society  notes that a person’s neutrophil count is

an important indicator of their infection risk.

An absolute neutrophil count (ANC) is a test that can help diagnose

conditions such as leukemia. It can also help healthcare professionals
assess how chemotherapy is affecting a person’s neutrophil count and
whether they need to pause treatment.

A person has neutropenia if their neutrophil levels drop below 1,000

neutrophils per µL of blood.

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 Symptoms
A person may not show symptoms if they have a low white blood cell
count. However, repeated infections may indicate leukopenia. The
symptoms of infection include:

fever

sweating
chills

toothache

sore throat
mouth ulcers that are difficult to heal

tiredness

flu-like symptoms
rash

A person with leukopenia may have other symptoms that relate to the
cause of their low white blood cell count.

Causes
Several medical conditions can cause leukopenia. Certain treatments and
medications may also cause leukopenia.

Conditions that may cause leukopenia

A person may develop leukopenia due to the following  conditions:

autoimmune conditions, such as rheumatoid arthritis, lupus, and

Sjögren’s disease
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cancers, such as Hodgkin lymphoma, leukemia, and myelofibrosis
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infection, such as influenza, HIV, and hepatitis
inflammatory
A D Vbowel disease
ERTISEMEN T (IBD) 
 granulomatosis with polyangiitis, which is a condition that causes the
inflammation of the blood vessels
a deficiency in folate, copper, or vitamin B12

inherited disorders, such as Chediak-Higashi syndrome or Kostmann

syndrome

COVID-19 may also result in a shortage of white blood cells.

Treatments and medications that may cause leukopenia

Certain cancer treatments may affect  a person’s white blood cell count,
leading to leukopenia. Treatments that may have this effect include:

chemotherapy

radiation therapy
bone marrow transplant

Some medications can also affect a person’s white blood cell count and
may lead to leukopenia.

Medications that can have this effect include :

quinidine

cephalosporin

aminopyrine

heavy metals
phenothiazine

sulfonamides

penicillins

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interferons, which treat multiple sclerosis

bupropion,Aan antidepressant and smoking cessation medication 

DVER TISEMENT
 immunosuppressants, such as sirolimus, mycophenolate mofetil,
tacrolimus, and cyclosporine

steroids

antipsychotic medications, such as  clozapine

If a person is unsure of the generic name of the drug they are taking, and
there is a chance it will affect their immune system, it is a good idea for
them to consult with a healthcare professional.
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Testing and workup

A healthcare professional will diagnose leukopenia with a blood test
called a complete blood count (CBC). A healthcare professional will take a
small blood sample to perform a CBC.

Blood consists of:

red cells, or erythrocytes, which transport oxygen from the lungs and
release it to the cells around the body
white cells, or leukocytes

platelets,
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A CBC
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also tests for hemoglobin (a protein in red cells involved in the
distribution of oxygen) and hematocrit (the percentage of red cells in a 
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person’s blood).
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Treatment
The United Kingdom’s National Health Service (NHS) states that treatment
for leukopenia depends on the cause of the condition.

A person may need antibiotics to fight infection. A person may also need
medication to boost their white blood cell count. It is important to never
stop or change a medication without first consulting a healthcare
professional.

If a person has cancer and their chemotherapy results in leukopenia, they

may need to pause their treatment to allow their white blood cells to
replenish.

Treatments that use growth factors, such as granulocyte colony-

stimulating factor, may help leukopenia. Healthcare professionals may
use these when chemotherapy is causing leukopenia or if the cause is
genetic.

Management
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The following home treatments and behaviors may help a person with
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leukopenia improve their condition and reduce their risk of infection:
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eating a healthy diet

getting plenty of rest

 avoiding cuts, scrapes, and damage to the skin
practicing good hygiene to avoid germs

maintaining good health

Some healthcare professionals may recommend following a neutropenic

diet. A neutropenic diet, otherwise known as a low bacteria diet, focuses
on eliminating foods that may contain microbes in an attempt to reduce
infection rates in those with weakened immune systems. However, a 2019
study  states that there is strong evidence against its use.

A 2018 study  notes that the neutropenic diet is difficult to follow. In

addition, it forces people to exclude fruits and vegetables from their diet.
It also limits the intake of meat and dairy products. The dietary restrictions
reduce the nutritional intake of people already at risk of experiencing
malnutrition.

The authors state that the Safe Food-Handling guidelines, which are
mandatory in all hospital kitchens, are enough to protect people against
food-borne infections.
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Outlook
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The outlook
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As leukopenia can make someone more prone to infection, they should

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take steps to remain healthy. They can do this by practicing good

 personal hygiene, eating a nutritious diet, and maintaining good oral
hygiene.

When to contact a doctor

If a person suspects they may be developing an infection, they should
speak with a medical professional.

A person should look for the signs of infection and avoid contact with
people who are ill.
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Summary
Leukopenia is when a person has a low white blood cell count. The most
common type of leukopenia is neutropenia, which refers to low levels of
neutrophils.

Although leukopenia has no symptoms, it makes a person more

susceptible to infections. As a result, a person should contact a doctor if
they develop recurrent infections.

Leukopenia
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medications. The treatment will depend on the underlying cause.
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 Last medically reviewed on December 21, 2021

Lymphoma Blood / Hematology Cancer / Oncology

Infectious Diseases / Bacteria / Viruses

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