Children who receive chemotherapy are at greater risk for infection. To determine the risk of infection, a blood test called a complete blood count with differential (CBC w/diff) may be ordered. Part of this test determines the patient's absolute neutrophil count or ANC.

A normal ANC is about 3,000-5,000. An ANC below 1,000 means your child is neutropenic and has a greater risk for infection. When the ANC is below 500, there is an even greater risk of developing a serious infection. The longer someone is neutropenic, the greater the risk of infection.

The ANC usually drops 7 to 10 days after receiving certain types of chemotherapy and stays down until the body is able to replace the damaged white blood cells. During the time period of low ANC, you will watch your child for signs of infection and report them. If your child has a low ANC and signs of infection he/she may need to be hospitalized and receive antibiotics to help fight the infection.

If your child’s ANC is low: 

  • Encourage everyone in the house to wash hands frequently.
  • Encourage your child to wash hands before eating and after using the bathroom.
  • Encourage your child to get plenty of rest.
  • Help your child perform good oral hygiene (rinse mouth, brush teeth after meals).
  • Help your child perform good physical hygiene (daily bathing, good hand washing).
  • Don’t go to crowded areas.
  • Don’t let people with colds or other infections visit your child.
  • Don’t give rectal medicines or use rectal thermometers.
  • Don’t allow your child to use douches, enemas, or tampons.

Call the clinic if:

  • Your child has a one time temperature of 101 F (38.3C) or higher.
  • Your child has a temperature of 100.3 F (38.0C) or more, lasting more than an hour.
  • Your child gets chills with a fever.
  • Your child has frequent vomiting, lasting diarrhea, or a severe headache.
  • Your child comes in contact with someone who has the chicken pox or measles.
  • Your child looks sick and you are concerned.

Some children receive Neupogen© (GCSF), a medicine that helps white blood cells recover.

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