Neutropenia is a haematological disorder that is characterized by an abnormally low blood level of one type of white blood cell, neutrophil granulocyte. This attack on the immune system of the body exposes the patient to a risk of infection, all the more important as the deficiency of the defense cells is important. Neutropenia is inherited or acquired, its causes are multiple (autoimmune, chemotherapy, drug …) and its degrees of severity very diverse, very light to very serious and life-threatening. Severe neutropenia is a common cause of cancer treatment.
Symptoms of Neutropenia
The symptoms of neutropenia are the multiple opportunistic bacterial and fungal infections that affect the patient. The risk of infection increases with the severity and duration of neutropenia. It develops preferentially on the skin and the mucous membranes, the ENT area and the lungs. Staphylococci, streptococci, enterococci, pneumococci and Pseudomonas aeruginosa (+++ link ++) are the most common agents of infection. The most common signs of neutropenia are: fever, chills, sore throat, mouth ulcers, bleeding gums, dental disorders, abdominal pain, diarrhea, lesions around the anus, pain during urination, coughing …
A blood count is used to measure the concentration of neutrophils in the blood and to measure the severity of neutropenia.
- Neutropenia is severe if the neutrophils (PN) count is less than 500 / mm3. It most often results from treatment against a cancerous tumor, chemotherapy, radiotherapy, or biological agents and poses a serious risk of infection.
- Neutropenia is moderate when the figure is between 1700 / mm3 and 1000 / mm3. It is benign and asymptomatic.
The origins of the disease
There are three types of white blood cells: monocytes, lymphocytes and granulocytes. These are divided between eosinophils, basophils … and neutrophils affected by neutropenia. They are produced in the bone marrow and the risk of neutropenia occurs when it no longer produces enough neutrophils, and / or when they are destroyed prematurely. Neutropenia can have various origins: infectious, drug, toxic, post-chemotherapy / radiotherapy, congenital, immune system disease (HIV).
Risk factors for Neutropenia
Severe acquired neutropenia is often caused by cancer treatment. Some chemotherapy and radiotherapy treatments can destroy, in addition to cancer cells, healthy cells of the body, among which white blood cells. The destruction of neutrophils often disrupts the administration of chemotherapeutic treatment. It should be noted, however, that not all chemotherapies induce severe neutropenia.
Prevention and treatment of Neutropenia
Recently developed drugs are prescribed to stimulate the production of neutrophils by the bone marrow (Neupogen, Neulasta …) and protect the body against the occurrence of infections. They are called granulocyte growth factors, or granulocyte growth factors. Antibiotics are given to fight opportunistic infections and the fever that frequently occurs in severe neutropenia. However, taking them too often increases the risk of infectious agents developing resistance to antibiotic treatments.