What is the normal level of Absolute Neutrophil Count (ANC)?

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Last updated: April 20, 2025View editorial policy

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From the Guidelines

The normal level of Absolute Neutrophil Count (ANC) in adults typically ranges from 1,500 to 8,000 neutrophils per microliter of blood. This range is crucial for determining the risk of infection, particularly in patients with fever and neutropenia, as highlighted in the practice guidelines for the diagnosis and management of skin and soft tissue infections 1. According to these guidelines, an ANC of less than 100 cells/µL is considered profound neutropenia, which significantly increases the risk of infection.

Key Points to Consider

  • The normal ANC range in adults is between 1,500 and 8,000 cells/µL.
  • An ANC below 1,500 is considered neutropenia, with severity classifications based on the count.
  • Monitoring ANC is essential for patients undergoing chemotherapy, those with certain infections, or individuals with autoimmune disorders, as noted in the guidelines for managing fever and neutropenia 1.
  • The calculation of ANC involves multiplying the percentage of neutrophils by the total white blood cell count, which is a critical value for assessing immune function.
  • Patients with anticipated prolonged and profound neutropenia or a Multinational Association for Supportive Care (MASCC) score of less than 21 are considered high-risk for infection, as per the guidelines 1.

From the Research

Normal ANC Level

The normal absolute neutrophil count (ANC) level is typically considered to be above 1.5 x 10^9/L [ 2, 3, 4 ].

Definition of Neutropenia

Neutropenia is defined as an ANC of less than 1.5 x 10^9/L [ 2, 3, 4 ]. Severe neutropenia is defined as an ANC of less than 0.5 x 10^9/L [ 5, 4 ].

Key Points

  • The risk of infection is greatest with severe neutropenia [ 5 ].
  • Neutropenia can be caused by various factors, including congenital marrow defects, intrinsic and acquired disorders [ 5 ].
  • Evaluation of patients with neutropenia should include confirmation of neutropenia, examination of a blood smear, and a careful review of the patient's medical history, family history, and physical examination [ 5 ].
  • The ANC level can be used to assess the severity of neutropenia and predict the risk of infection [ 2, 3, 4 ].

ANC Levels in Different Conditions

  • In patients with aplastic anemia, the median ANC was 594/cmm (range 25-3850) [ 6 ].
  • The ANC level was significantly lower in aplastic anemia than in other causes of pancytopenia [ 6 ].

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hematologic Conditions: Leukopenia.

FP essentials, 2019

Research

How I diagnose and treat neutropenia.

Current opinion in hematology, 2016

Research

Neutropenia: causes and consequences.

Seminars in hematology, 2002

Research

Absolute Neutrophil Count in Cases of Pancytopenia.

The Journal of the Association of Physicians of India, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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