Low Blood Counts

21.03.2024

LOW BLOOD COUNTS IN CANCER TREATMENT

During cancer treatment, patients often face hematological (blood) side effects, which constitute one of the challenging aspects of the treatment process. Especially due to the effect of chemotherapy on the bone marrow, decreases in blood cells such as white blood cells (neutropenia), red blood cells (anemia) and platelets (thrombocytopenia) may occur. These conditions increase the risk of infection, can lead to symptoms such as fatigue and shortness of breath, and also increase the risk of bleeding and bruising. Cancer treatment aims to reduce these side effects and provide patient care with appropriate medications and supportive treatments.

Drugs that can cause low blood counts ​​in cancer treatment are generally chemotherapy drugs. Among them:

Anthracyclines (e.g. doxorubicin): It may decrease hemoglobin and leukocyte counts.

Alkylating Agents (e.g. cyclophosphamide): May cause a decrease in red and white blood cells.

Platinum-based drugs (eg, cisplatin): May affect platelet levels.

Antimetabolites (Eagle: methotrexate): It may lead to a decrease in the overall blood cell count.

Regular blood tests and, if necessary, supportive treatments are important during the use of these medications.

Image 1: During the cancer treatment process, blood tests are performed before treatment to evaluate suitability for treatment.

Types of side effects and treatments

While chemotherapy targets cancer cells, it can also affect the body's healthy cells. This may lead to significant hematological side effects, especially on blood cells. Treatment of hematological side effects associated with chemotherapy varies depending on the type and severity of these side effects.

Hematological side effects associated with chemotherapy may include:

Neutropenia: Chemotherapy can reduce infection-fighting white blood cells (especially neutrophils). This makes patients more vulnerable to infections and increases the risk of infection. Neutropenic patients should be closely monitored for signs of infection such as fever and antibiotic treatment should be administered when necessary. Additionally, patients with neutropenia should avoid crowded places and sick people.

Neutropenia Treatment: Medications such as granulocyte colony-stimulating factors (G-CSF) or granulocyte/macrophage colony-stimulating factors (GM-CSF) are used to increase white blood cell counts. These drugs help white blood cells recover faster after chemotherapy. Examples include filgrastim, sargramostim, and peg-filgrastim.

Infection Control:Antibiotic prophylaxis and alertness for signs of infection are important for neutropenic patients. Fever and other signs of infection require prompt medical attention.

Image 2: During cancer treatment, blood booster injections or blood products may be administered due to low blood values.

Anemia: Red blood cells carry oxygen to all parts of the body. Chemotherapy can reduce the number of these cells, which can lead to symptoms such as fatigue, weakness, and shortness of breath.

Anemia Treatment: In cases of severe anemia, red blood cell transfusions can be performed. Erythropoietin or similar medications can help treat anemia by stimulating red blood cell production.

Thrombocytopenia (Decrease in Platelets): Platelets play an important role in blood clotting. Chemotherapy can lower platelet counts, which can increase the risk of bleeding and bruising.

Thrombocytopenia Treatment: For very low platelet counts, platelet transfusions may be given to prevent bleeding. Patients with low platelet counts should avoid cuts and injuries and use gentler dental care.

Hematological Cancers: Rarely, some chemotherapy drugs, especially long-term or high-dose treatments, can lead to secondary types of cancer (for example, leukemia).

Management of these side effects is crucial to maintaining the patient's overall health and completing the treatment process safely. These treatments should be individualized based on the patient's overall health, chemotherapy regimen, and other relevant factors. Close cooperation of patients and healthcare teams and regular blood tests are important in the management of hematological side effects. It is important for patients to consult a healthcare provider when any suspicious symptoms occur.