Chemotherapy can reduce the number of blood cells made by the bone marrow, including white blood cells, which fight and prevent infection. If the number of your white cells is low you are more likely to get an infection. The main white cells which fight bacteria are called neutrophils, so when they are low you are described as neutropenic.
Your resistance to infection is usually at its lowest 7–14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due. If you get an infection as a result of the side-effects of chemotherapy – when the body is already compromised – it is considered to be a medical emergency and you may need hospital admission for treatment with antibiotic intravenous (IV) infusions.
You can manage your personal risk actively by taking these precautions:
The people most at risk of developing this serious problem are often older patients who also have poor general health and other underlying health issues with heart, kidney or other problems with major organs. People who have a low white blood cell count as a result of previous chemotherapy treatments or current chemotherapy in high doses may also be at risk.
Prior to each cycle of chemotherapy you will have your blood levels checked and be carefully assessed for any signs and symptoms of infection. Your chemotherapy team should give you a special card with the signs and symptoms to look out for, and an emergency contact number that is active 24 hours a day. Where your personal risk is considered to be high, medications can be prescribed to increase the production of white blood cells, to help you recover more quickly from chemotherapy.
Chemotherapy is a toxic treatment and each person’s ability to deal with this varies. All precautions are taken to reduce the risk of the treatment to you. Very occasionally it is necessary to carry out certain blood tests to see if you are particularly at risk prior to starting treatment. Your oncologist will discuss the possible risks to you and allow you time for questions.