From the Guidelines
A neutrophil count of 65 cells/mm3 indicates a severely compromised immune system, putting the patient at a high risk for infection. This is because, according to the guidelines for the use of antimicrobial agents in neutropenic patients with cancer 1, a neutrophil count of less than 1000 cells/mm3 increases susceptibility to infection, with the frequency and severity inversely proportional to the neutrophil count. Key points to consider in this scenario include:
- The patient's neutrophil count is significantly below the threshold of 1000 cells/mm3, indicating a high risk for infection 1.
- The duration of neutropenia is also an important determinant of infection, with protracted neutropenia (i.e., neutrophil count of less than 500 cells/mm3 for 10 days) being a major risk factor for impending infection 1.
- Patients with neutrophil counts as low as 65 cells/mm3 are at an even greater risk for infection than those with counts of 500 cells/mm3 or higher 1. Given this information, it is crucial to closely monitor the patient for signs of infection, such as fever, and to consider prompt medical intervention, including the use of antimicrobial agents, to prevent or treat any potential infections.
From the Research
Neutrophil Count
- A neutrophil count of 65 is not explicitly mentioned in the provided studies, but we can discuss the general context of neutropenia and its treatment.
- Neutropenia is defined as an absolute neutrophil count (ANC) less than 1.5 × 10^9/L, with severe neutropenia being an ANC less than 0.5 × 10^9/L 2.
- The normal neutrophil count ranges from 1,500 to 8,000 cells per microliter (μl) of blood.
Treatment of Neutropenia
- Granulocyte colony-stimulating factor (G-CSF) is a common treatment for neutropenia, especially for patients with severe chronic neutropenia 2, 3, 4.
- G-CSF can increase neutrophil counts and reduce the risk of infections in patients with neutropenia 3, 4.
- The use of G-CSF is recommended when the risk of febrile neutropenia is greater than 20% 5.
Diagnosis and Management
- Determining the cause of a low neutrophil count is essential for clinical decision-making 6.
- Diagnostic tests, such as peripheral blood smears and bone marrow biopsies, are important tools in evaluating neutropenic patients 6.
- Evaluating for immune disorders and genetic testing is also crucial in diagnosing neutropenic disorders 6.