Low blood cell count with chemotherapy

Low blood cell count with chemotherapy

All chemotherapy treatments temporarily affect your blood counts. The drugs can reduce the number of healthy blood cells (white blood cells, red blood cells and platelets) in the blood.

You will have regular blood tests throughout your treatment to check your blood cell counts. If numbers are too low, doctors may:

• delay your chemotherapy until your blood count recovers
• reduce the chemotherapy dose
• give you an injection to boost your number of white cells
• give you a blood transfusion to increase the number of red cells.

There are several possible side effects to look out for.

Infection

An increased risk of infection can be a serious side effect of chemotherapy. The white blood cells in your body that help fight infection can become low. When your main type of white cell ('neutrophils') are low, this is called neutropenia. Your white cells are at their lowest usually 1 to 2 weeks after chemotherapy but differs between chemotherapy drugs. This is when your resistance to infection is usually at its lowest.

White cell counts usually return to normal pretty quickly, usually before the next chemotherapy dose is due.

When to contact your doctor

Look out for raised temperature (over 38 degrees), sweating, shaking and chills. If you experience these side effects:

• contact your doctor or nurse immediately
• go to your closest emergency department
• contact the out of hours number your treating team as given you.

Treatment

You will get antibiotics immediately, to ensure that if you have an infection it is treated promptly.

Your doctor may also recommend medication to encourage white cell production and reduce your risk of infection. This is usually an injection of a drug called GCSF, such as filgrastim or pegfilgrastim.

Low red blood cell count (‘anaemia’)

Anaemia can make you feel very tired, dizzy and breathless.

When to contact your doctor

It is important to let your doctor know if you experience extreme fatigue, or you are dizzy or short of breath.

Treatment

You may need a blood transfusion if your red blood cell count is very low. Tell your doctor or nurse in advance if you do not want a blood transfusion due to religious reasons.

Bleeding or bruising

Chemotherapy can affect the cells in your body (‘platelets’) that help your blood to clot. This may make you bleed or bruise easily.

This is a rare side effect that can happen 1 to 2 weeks after treatment.

When to contact your doctor

Tell your doctor as soon as possible if you:

• bruise easily
• bleed a lot or for a long time from your gums or nose
• have reddish urine
• have black or bloody bowel motions (poo).

If you notice these at night or on a weekend, call the out-of-hours number your doctor gave you or contact your local hospital emergency department.

Treatment

Your doctor will check your platelet count while you are having chemotherapy. You may need a platelet transfusion if your count is very low.