Reduced blood cell count is a common yet serious complication of cancer treatments like chemotherapy. That's why your blood cell count is very closely monitored by your specialist during your treatment. You frequently have to give blood tests like CBC w/diff to analyse your blood cell counts. During this test, doctors or nurses draw a small amount of blood to perform a blood test.

Also Read: Complete Blood Count (CBC)

How does chemotherapy affect your blood count?

Chemotherapy uses chemodrugs to kill the fast-dividing cancer cells. But it doesn't differentiate between healthy and cancer cells. So, healthy cells get killed too in this process. Chemotherapy can affect the cells in the bone marrow, which is the factory of all blood cells. Bone marrow is sensitive to chemotherapy. Hence, the blood count decreases. Blood consists of white blood cells, red blood cells, and platelets. White blood cell count is especially affected, and its circulation temporarily falls due to chemotherapy. Other blood cell counts decrease too due to chemotherapy.

When do the blood counts fall?

Just after a few days of receiving the chemotherapy, the blood counts start to fall. It is at the lowest level in the second or third week after the chemotherapy. Slowly, when your bone marrow starts to recover on its own, your blood counts begin to level up again. Hence, before every cycle of chemotherapy, doctors test your blood count to ensure that it has returned to the normal range. In short, you are ready to receive your chemotherapy sessions again.

Why are low blood counts serious?

Blood performs some vital bodily functions. For example, red blood cells carry oxygen to the cells of all the body parts. While the white blood cells are the protectors or defenders of our body. They protect us from the attacks of pathogens and other intruders. In the absence of these cells, our body becomes vulnerable to infections. A simple infection can become uncontrollable.

But don't worry because low blood counts don't mean that you will get any infections. Almost all people have low blood count during the chemotherapy treatment. A few of them develop serious infections.

Complications of low blood count

Low blood cell counts can delay the next treatment process, reduce the dosage to the doctor, or prescribe new medications. By monitoring blood cell counts, doctors can prevent or reduce the risk of complications. The most serious complications of low blood cell counts include:

Infection: Low white blood cell counts, especially low neutrophil counts, increase the risk of developing an infection. Chemotherapy can be delayed even with mild infections. This is because the doctor waits until the infection is resolved and the blood cell count increases before continuing. Your doctor may also recommend medicines to increase the production of white blood cells in your body.

Also Read: Blood Cancer And Its Complications And Ways To Manage It

Anaemia: A low red blood cell count is anaemia. The most common symptoms of anaemia are fatigue and shortness of breath. In some cases, fatigue becomes severe and cancer treatment may need to be temporarily stopped or the dose received may be reduced. Mild anaemia is common and often does not cause fatigue, but tell your doctor if you have these symptoms and see if anaemia is a possible cause. A blood transfusion can help to cope with anaemia.

Bleeding: A low number of platelets in the blood can cause bleeding. Large amounts of bleeding can occur from small cuts and spontaneous bleeding from the nose and gums. In rare cases, dangerous internal bleeding can occur. Low platelet counts can delay treatment. You may have to wait for your platelet count to increase before you continue chemotherapy. If your platelet count is low, you can also treat it with a platelet transfusion.

How can you cope with the decrease in blood cell count?

If your blood cell count is low, take steps to keep your body healthy.

Eat a balanced diet. Your body needs all the vitamins and nutrients that can heal itself during and after your treatment. Choose lots of fruits and vegetables. If treatment complications make eating difficult (for example, nausea, vomiting, or mouth sores), experiment to find acceptable foods.

Don't get hurt: Many daily activities carry the risk of cuts and abrasions. With a low platelet count, even the slightest scratches can be serious. With low white blood cell counts, small cuts can be the starting point for serious infections. Use an electric razor instead of a razor to avoid scratches. Ask someone else to cut the food in the kitchen. Be gentle when brushing your teeth or blowing your nose.

Avoid pathogens: If possible, avoid unnecessary contact with bacteria. Wash your hands frequently or use a liquid hand sanitiser. Avoid sick people and stay away from the crowd. Ask someone else to clean the toilet, birdcage, or aquarium. Do not eat raw meat or eggs. Talk to your healthcare team about other ways to manage low blood cell counts.

Stopping chemotherapy for a while

If the blood cell count is too low, the doctor may have to postpone the next treatment until the blood cell count recovers. This is sometimes referred to as a chemotherapy pause.

It's not that important. The effectiveness of the treatment is not diminished. However, if it happens too often, or if chemotherapy is affecting the kidneys (for example), you may need to take lower doses of the drug.

It is important not to consider this a setback. Some people are more susceptible to chemotherapy than others, and doctors need to take this into account when adjusting their doses.

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Reference:

1. Connolly GC, Khorana AA, Kuderer NM, Culakova E, Francis CW, Lyman GH. Leukocytosis, thrombosis and early mortality in cancer patients initiating chemotherapy. Thromb Res. 2010 Aug;126(2):113-8. doi: 10.1016/j.thromres.2010.05.012. PMID: 20684071; PMCID: PMC3635827.