Neutropenia: A nursing perspective

Abstract

Neutropenia is the most common dose-limiting toxicity of chemotherapy. It is considered an unpreventable side effect of many types of cancer treatment. It may be a side effect of therapy or a planned aspect of a conditioning regimen for bone marrow or hematopoietic stem cell transplantation (HSCT). The definition of neutropenia differs among institutions, ranging from an absolute neutrophil count (ANC) of less than 500 cells/mm to less than 1500 cells/mm. Neutropenia can lead to infection, increased length of stay (LOS), delay, reduction, or discontinuation of cancer treatment, and increased morbidity and mortality. More than 60,000 patients with cancer are hospitalized annually in the United States for chemotherapyinduced neutropenia (CIN). Older patients with cancer may be more vulnerable for infection and death than their younger counterparts. The typical duration of neutropenia is 7-10 days but will vary based on the patient’s age, chemotherapy agent(s) received, comorbidities, and bone marrow reserve. Although patients cannot prevent CIN from occurring, there are a number of actions nurses and patients can take in order to help mitigate developing an infection while neutropenic.