From the Guidelines
The absolute neutrophil count (ANC) is the part of a differential count that indicates a neutrophil count of 1500 cells per microliter (µL), including immature forms such as band neutrophils. This measurement is crucial in assessing the risk of infection and monitoring disease progression, particularly in patients with conditions like chronic lymphocytic leukemia (CLL) 1. The ANC is calculated by multiplying the total white blood cell count by the percentage of neutrophils (both segmented and band forms) found in the differential count. According to the guidelines for the diagnosis and treatment of CLL, an ANC of 1500 cells/µL is considered a significant threshold, with values below this level potentially indicating neutropenia and increased risk of infection 1.
Key points to consider when interpreting the ANC include:
- The ANC provides a specific quantification of neutrophils in the bloodstream, which are essential for fighting bacterial infections.
- The inclusion of band neutrophils (immature forms) in this count is important because these cells are released from the bone marrow during acute infections as part of the body's immune response.
- An ANC of 1500 cells/µL is generally considered the lower limit of normal, with values below this threshold potentially indicating neutropenia.
- Healthcare providers use the ANC to assess infection risk, monitor disease progression, and evaluate the effects of treatments like chemotherapy that may suppress neutrophil production 1.
In clinical practice, the ANC is a critical component of the complete blood count (CBC) and is used to guide treatment decisions and monitor patient outcomes. For example, in patients with CLL, an ANC of 1500 cells/µL may indicate the need for growth factor support or other interventions to reduce the risk of infection 1.
From the Research
Neutrophil Count Indication
- The absolute neutrophil count (ANC) is a measure that can indicate the number of neutrophils in the blood, including immature forms such as band neutrophils 2, 3.
- An ANC of 1500 cells per microliter (µL) can be considered low, as a normal ANC typically ranges from 1,500 to 8,000 cells per microliter 4.
- The differential count, which includes the ANC, can provide information on the types and numbers of white blood cells, including neutrophils, in the blood 2, 3.
Immature Neutrophils
- Immature neutrophils, such as band neutrophils, can be an indication of infection or inflammation in the body 4.
- However, the presence of neutrophils more immature than bands, rather than the band count itself, may be a better indicator of infection in patients with a normal total leukocyte count 4.
Measurement of Neutrophil Count
- Automated hematology instruments can provide accurate and precise measurements of ANC, even at low levels 3.
- The use of G-CSF and GM-CSF may be considered in the management of infections in preterm newborns with severe neutropenia, but its use is not recommended for prophylaxis of infections in the presence of neutropenia 5.