Leukopenia

Leukopenia Definition

Leukopenia or leucopenia or leukocytopenia is a decrement in the white blood cells (WBC) or leukocytes present in the blood that places individuals at greater infection risks. Leukopenia derived its name from Greek words meaning deficiency and white. A subtype of leukopenia called as neutropenia is referred to decline in the number of neutrophil granulocytes that are the most abundant WBCs. Neutrophil being the most crucial infection risk indicator, neutropenia and leukopenia might be used interchangeably.

Usually, less than 3,500 WBC/mL of blood is regarded as a low WBC count. Low WBC count threshold in children varies according to the age and gender. Leukopenia is believed to weaken the immune system of the body, thereby putting the individuals at high infection risks.

Leukopenia Types

Leukocyte or WBCs are found in lymphatic system or blood, and they are the immune-system cells. They are derived from the bone marrow’s multi-potent cell called as the hematopoietic stem cell. These WBC protect the body from infections, foreign particles and diseases.

1. Neutrophils: defend the body against fungal or bacterial infections.
2. Basophils: respond to allergies by releasing histamine that causes inflammation.
3. Eosinophils: deal with parasitic infections.
4. Monocytes: they function similar to neutrophils, and present pathogen pieces to T cells that can very well identify these pathogens to kill them.
5. Lymphocyte: make antibodies; kill cells that are cancer infected or viral; co-ordinate the immune response.

Leukopenia Symptoms

• Anemia
• Thrombocytopenia: Low platelets due to bone marrow damage that decreases WBCs
• Pneumonia: Inflammation of lungs due to bacteria or virus
• Stomatitis: Inflammation of mucous lining of gums, cheeks, lips, tongue, etc.
• Liver abscesses: Bacterial infection of the liver
• Metrorrhagia: Infective bleeding from the uterus
• Menorrhagia: Prolonged and heavy menstruation
• Neurasthenia: Characterized by fatigue, fever, headache, irritability and hot flashes
• Oral ulcer and various infections
• Strong desire to consume hot drinks

Leukopenia Causes

Cold/flu

• Low WBC count is seen

Leukemia

• Bone marrow gets damaged, and normal marrow cells are replaced with immature WBC

HIV and AIDS

• These immune deficient diseases disrupt the function of bone marrow thereby decreasing WBC production.

Chemo therapy and radiation therapy

• Kills cancerous cells along with healthy blood cells

Aplastic anemia

• Failure to produce WBC and RBC, and also poor production of platelets

Myelofibrosis

• Fibrous tissue replaces the bone marrow

Hodgkin’s lymphoma

• Damage the bone marrow

Rheumatoid arthritis
Systemic Lupus Erythematosus

• This chronic anti-immunity connective disorder damages tissues, and causes infection

Congenital disorders

• Kostmann’s syndrome: it has low neutrophil production
• Myelokathexis: neutrophils fail to enter the blood stream

Diseases like typhoid, rickettsial infections, tuberculosis, malaria and dengue
Spleen enlargement

• Destruction of blood cells by the spleen

Folate deficiency
Sepsis and psittacosis
Medications like diuretics and antibiotics, antipsychotics and antidepressants

• Damage bone marrow

Deficiency of minerals like zinc and copper

Leukopenia Diagnosis

1. Leukopenia can be diagnosed with a complete blood count.

• This test determines the amount of WBC in the blood stream; depending on the WBC count, the seriousness of the problem is determined.

2. Flow cytometry (to rule out leukemia)

• In this technique, cells and chromosomes are counted and examined by suspending them in a fluid stream, and passing through an electronic detection apparatus.

3. A bone marrow biopsy (if not diagnosed by CBC)

Leukopenia Precautions

• This is done mainly to minimize the infection risks.
• Frequent hand washes with plenty of water and soap.
• Wear mask and gloves wherever possible.
• Usage of body lotion after every wash (dry skin is more susceptible to infections).
• Avoid large crowds (this may contain infected people).
• Stay away from sharp objects that can cause injury.
• In case of trauma or wounds, consult a medical practitioner immediately.
• Nutritious meal consisting of essential minerals and vitamins, especially, iron, zinc and copper to improve the WBC count.

Leukopenia Treatment

A reduced leukocyte count is not life-threatening. However, inability to resist infections due to low immunity may lead to serious symptoms and even death. Hence, having a thorough knowledge about the symptoms of leukopenia and its treatment will assist in minimizing the resultant complications of leukopenia.

To activate the bone marrow

• Antibiotics: for bacterial infection and sepsis
• Dietary supplements: for nutrient deficiency
• Cytokine therapy

The growth factors contain cytokines that stimulate the bone marrow for producing more WBCs.

Eg: Filgrastim and pegfilgrastim

Chemotherapy

It is contraindicated or delayed, if the leukopenia is due to previous chemotherapy

Ex vivo expansion

It is still in a clinical trial process. This process grows neutrophils in the laboratory to infuse it into patients who are on chemotherapy, for preventing neutropenia

Cocktail of drugs

In severe conditions

References

http://en.wikipedia.org/wiki/Leukopenia

http://www.seattlecca.org/diseases/leukopenia.cfm

http://www.mayoclinic.com/health/low-white-blood-cell-count/MY00162

http://www.news-medical.net/health/Leukopenia-What-is-Leukopenia.aspx

http://www.buzzle.com/articles/symptoms-and-treatment-of-leukopenia.html

http://www.beltina.org/health-dictionary/leukopenia-symptoms-causes-treatment.html

http://leukopeniadisease.com/