What are the symptoms of leukopenia?

Written by Tang Zhuo
Endocrinology
Updated on September 23, 2024
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Leukopenia is a common hematological disorder that can occur at any age. It is defined as leukopenia when the total number of white blood cells in the peripheral blood consistently falls below four times ten to the ninth power per liter. The onset of this disease is usually gradual with mild symptoms such as fatigue, palpitations, dizziness, low fever, prone to pharyngitis or mucosal ulcerations, and also includes loss of appetite, limb fatigue, insomnia with frequent dreams, and a cold stomach and backache. It makes one more susceptible to viral and bacterial infections such as colds. If leukopenia is caused by an infection, common symptoms include high fever, chills, and body aches. If the total number of white blood cells is significantly reduced, with an absolute neutrophil count below 0.5 times ten to the ninth power per liter, it is referred to as neutropenia. In such cases, the patient may experience chills, high fever, sore throat, headache, joint pain, and in severe cases, even coma and death.

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Is leukopenia severe?

The normal value of white blood cells in the human body is 4 to 10×10^9/L. White blood cells mainly consist of neutrophils and lymphocytes, along with some other types of eosinophilic and basophilic granulocytes. If the total white blood cell count decreases, generally falling below 4 to 10×10^9/L, it is referred to as leukopenia. Among these, neutrophils are the most related to the body's immune response. If neutrophils decrease to less than 1.5×10^9/L, it is defined as neutropenia, which is very serious. If neutropenia occurs, the resistance to infections is greatly lowered, making the body highly susceptible to various infections. Active treatment to increase white blood cells is necessary; otherwise, any infection may lead to severe conditions like septicemia and septic shock, which can even be life-threatening.

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Written by Yang Li
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Does leukopenia lead to leukemia?

First of all, a concept to clarify: generally, leukemia is associated with a very high white blood cell count. So, does a decrease in white blood cells lead to leukemia? There is no direct causal relationship between the two. A reduction in white blood cells generally requires an analysis of its cause—whether it is due to a decline in hematopoietic function, a deficiency in raw materials, or an increase in destruction. These situations essentially involve issues in the production factory or where they are used. We cannot say that people with reduced white blood cells will not develop leukemia, nor can it be stated in that way. They may also, over a period, exhibit a reduction in white blood cells due to certain factors. So, if there are genes causing leukemia combined with other factors, leukemia might occur, but there is no direct causation between the two.

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Written by Zhang Jun Jun
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Is leukopenia leukemia?

Leukopenia is not necessarily indicative of leukemia. There are many causes for a decrease in white blood cells, some of which can be due to medications. Currently, many drugs can cause a reduction in white blood cells, and in such cases, stopping the drug will typically allow the white blood cells to return to normal. A second scenario, especially in patients with an enlarged spleen or those suffering from cirrhosis, can also lead to a decrease in white blood cells. In these cases, it is mainly the abnormal function of the spleen that causes the reduction in white cells. Additionally, there are blood-related diseases, which might be leukemia or other types of blood disorders. In these situations, not only is there a reduction in white blood cells, but there is also a decrease in hemoglobin and platelets. Moreover, a significant increase in white blood cells is also a manifestation of leukemia, thus a decrease in white cells is not definitively indicative of leukemia.

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Written by Zhang Jun Jun
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Is leukopenia very harmful?

Leukopenia primarily depends on the extent of the decrease in white blood cells, which can be classified into mild, moderate, and severe levels. Mild leukopenia generally means less than 4.0 X 10⁹/L, and if granulocytes are decreased, it typically means an absolute value of granulocytes less than 2.0 X 10⁹/L. A lack of granulocytes indicates a more severe condition, usually less than 0.5 X 10⁹/L. For patients with mild leukopenia, special preventive measures are generally not necessary. However, for moderate and severe leukopenia, the greatest risk is an increased chance of infection, as white blood cells are a marker of our ability to defend against external threats. With fewer of these defensive guards, the probability of resisting infections and the chance of acquiring infections significantly increase. Therefore, for patients with moderate leukopenia, their rate of infection increases, and it is important to take precautions, reduce visits to public places, maintain hygiene, and eliminate chronic infectious foci. For patients with severe leukopenia, aseptic isolation measures should be adopted. For patients who have infections, it is crucial to find sensitive antibiotics, preferably broad-spectrum antibiotics. If there is a concurrent fungal or viral infection, antifungal or antiviral medications should also be used, as the decrease in white blood cells can destroy a person's immune capacity, lowering immunity and increasing the chance of infections and the invasion of pathogenic bacteria, which in severe cases could even lead to sepsis or septic shock.

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What to check for the cause of leukopenia?

If there is a decrease in white blood cells, we mainly look at the total number of white blood cells and the absolute value of neutrophils in our routine blood test. The causes of leukopenia are inseparable from neutrophils, and can be mainly divided into three categories. The first category is a production defect of neutrophils, the second is excessive destruction and consumption of neutrophils, and the third is abnormal distribution of neutrophils. A major cause of decreased production of white cells and neutrophils is damage to hematopoietic stem cells by ionizing chemicals. Additionally, immune reactions and bone marrow diseases can also lead to decreased production. Another cause is a production defect due to maturation disorders in neutrophils within white blood cells, leading to reduced white blood cell production. Maturation disorders are mainly due to a lack of raw materials needed for white blood cell production. Excessive destruction and consumption of white blood cells are often due to immune factors. Immune factors are common in autoimmune diseases, thus such diseases can also lead to leukopenia. The last category, abnormal distribution, can be a severe infection that causes an abnormal distribution of white cells, retaining them alongside other substances, such as in patients with enlarged spleens, which can provoke leukopenia by causing granulocytes to be retained in circulation, especially in areas like the spleen.