From the Guidelines
A normal absolute neutrophil count (ANC) typically ranges from 1,500 to 8,000 neutrophils per microliter of blood in adults. This range may vary slightly between different laboratories and for different populations. An ANC below 1,500 is considered neutropenia, with severe neutropenia being below 500, which significantly increases infection risk 1. Neutrophil counts can fluctuate throughout the day and in response to various factors including stress, exercise, infections, and certain medications. During infections, the count often increases above normal levels (neutrophilia), which is a normal immune response. Some key points to consider when evaluating ANC include:
- Neutrophils are the most abundant type of white blood cell and serve as the body's first line of defense against bacterial and fungal infections 1.
- They work by engulfing and destroying pathogens through a process called phagocytosis.
- Regular monitoring of neutrophil counts is important for individuals with chronic conditions, those undergoing chemotherapy, or those taking medications that can affect bone marrow function.
- An absolute neutrophil count that is depressed because of HIV disease or drug therapy is associated with an increased risk for bacterial infections, including pneumonia 1. It's worth noting that while the provided studies discuss various aspects of neutrophil counts and their implications, the definition of a normal ANC range is not directly addressed in these studies. However, based on general medical knowledge and the information provided, the typical range of 1,500 to 8,000 neutrophils per microliter of blood in adults is widely accepted.
From the FDA Drug Label
The recommended starting dosage of NEUPOGEN is 5 mcg/kg/day‚ administered as a single daily injection by subcutaneous injection‚ by short intravenous infusion (15 to 30 minutes)‚ or by continuous intravenous infusion Obtain a complete blood count (CBC) and platelet count before instituting NEUPOGEN therapy and monitor twice weekly during therapy. Consider dose escalation in increments of 5 mcg/kg for each chemotherapy cycle‚ according to the duration and severity of the absolute neutrophil count (ANC) nadir. Recommend stopping NEUPOGEN if the ANC increases beyond 10‚000/mm3
A normal absolute neutrophil count (ANC) is not explicitly defined in the provided drug label, but it is mentioned that NEUPOGEN should be stopped if the ANC increases beyond 10,000/mm3 2.
From the Research
Normal Absolute Neutrophil Count
- A normal absolute neutrophil count (ANC) is generally considered to be above 1.5 × 10^9/L or 1,500/µl 3, 4, 5.
- This value is used as a threshold to diagnose neutropenia, which is a condition characterized by a low number of neutrophils in the blood.
- Neutropenia can be classified into different severity levels, including:
- Severe: ANC < 500/µl
- Moderate: ANC between 500 and 1,000/µl
- Mild: ANC between 1,000 and 1,500/µl 3
- It's worth noting that the normal range for ANC can vary slightly depending on the laboratory or institution, but 1,500/µl is a commonly used threshold 4, 5.
Comparison of Studies
- Multiple studies have used an ANC of 1.5 × 10^9/L or 1,500/µl as a threshold to diagnose neutropenia 3, 4, 5.
- These studies have also highlighted the importance of ANC in evaluating the risk of infection and guiding treatment decisions in patients with neutropenia 4, 5, 6, 7.
- While there may be some variation in the normal range for ANC, the threshold of 1,500/µl is widely accepted and used in clinical practice 3, 4, 5.