From the Guidelines
Leukopenia is a condition characterized by an abnormally low white blood cell count in the blood, specifically a total white blood cell count below 4,000 cells per microliter of blood in adults. To diagnose leukopenia, a complete blood count (CBC) test is required [ 1 ]. If confirmed, further testing may be needed to determine the underlying cause. Common causes of leukopenia include:
- Viral infections
- Certain medications (e.g., chemotherapy drugs, antibiotics)
- Autoimmune disorders
- Bone marrow disorders
- Severe infections Treatment depends on the underlying cause and may include:
- Stopping or changing medications that may be causing the condition
- Treating underlying infections or diseases
- In severe cases, medications to stimulate white blood cell production (e.g., Filgrastim) may be prescribed, although the use of growth factors should be avoided in patients with moderate-to-severe SARS-CoV-2 infection [ 1 ]. Patients with leukopenia are at higher risk for infections due to reduced immune function. They should take precautions such as:
- Practicing good hygiene
- Avoiding crowds and sick individuals
- Eating a healthy diet to support immune function
- Seeking prompt medical attention for signs of infection Understanding leukopenia is important because white blood cells are crucial for fighting infections and maintaining overall health. A low count can significantly impact the body's ability to defend against pathogens. In the context of COVID-19, patients with haematological malignancies and neutropenia are potentially at a higher risk of having severe COVID-19, and empirical antibacterial therapy should be initiated promptly pending further workup [ 1 ].
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition of Leukopenia
- Leukopenia is a common finding in the outpatient setting, typically occurring due to a significant reduction in neutrophils, which comprise 50% to 70% of circulating leukocytes 2
- It is an abnormal reduction of circulating white blood cells, especially the granulocytes, and is often used interchangeably with neutropenia 3
- Leukopenia is a blood disease in which the number of circulating white blood cells diminishes, and can result from reduced production of white blood cells or increased utilization and destruction, or both 3, 4
Causes of Leukopenia
- Infection, drugs, malignancy, megaloblastosis, hypersplenism, and immunoneutropenia are responsible for most cases of neutropenia 3
- Primary neutropenia is very rare, and sometimes, particularly in children, primary neutropenia is hereditary and may be associated with other developmental defects 3
- Familial Mediterranean fever (FMF) can cause leukopenia, mainly due to autophagy and apoptosis processes 4
- In children, decreased leukocyte values are usually due to the decrease in the number of neutrophilic granulocytes, and can be associated with viral infections or immune-mediated neutropenias 5
- Certain medications, such as acyclovir, can also cause transient leukopenia and erythroblastopenia 6
Clinical Implications
- The major danger of neutropenia is the risk of infection, and management requires identification of the cause and effective antimicrobial therapy, especially when serious systemic infection is present 3
- Patients with febrile neutropenia should undergo treatment with antibiotics, and other treatments are aimed at management of the underlying cause of neutropenia 2
- Early recognition of underlying conditions, such as FMF, can help to prevent unnecessary invasive procedures and complications, such as amyloidosis 4