What causes leukopenia?

Written by Liu Lei
Endocrinology
Updated on September 11, 2024
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Leukopenia mainly has the following three causes: 1) Drugs; 2) Infections; 3) Diseases that cause disturbances in white blood cell production. Drugs primarily include antibiotics such as sulfonamide antibiotics and penicillin; anti-tuberculosis drugs like rifampicin and isoniazid; anti-thyroid drugs such as methimazole and propylthiouracil; antipyretic analgesics like aminopyrine, indomethacin, and ibuprofen; and antihistamines such as diphenhydramine. Additionally, most chemotherapy drugs can cause a decrease in white blood cells. Viral infections can lead to a decrease in white blood cells or severe bacterial infections, such as sepsis and septicemia, along with some chronic infections. Diseases that cause disturbances in the production of white blood cells mainly refer to certain hematological diseases, such as aplastic anemia or malignant tumors that invade the bone marrow and affect hematopoiesis. Furthermore, there are some less common causes of leukopenia, such as familial inheritance and granulocyte distribution disorders.

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Written by Zhang Jun Jun
Endocrinology
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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 Zhao Xin Lan
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Can you eat pumpkin with leukopenia?

Leukopenia has no significant relation to consuming pumpkin. The main nutritional contents of pumpkin are starch, which ultimately breaks down into fructose and glucose, and pumpkin also contains a large amount of cellulose. Fructose, glucose, and cellulose do not cause leukopenia, so it is safe for people with leukopenia to eat pumpkin. The primary causes of leukopenia are usually related to disturbances in the hematopoietic function of the bone marrow, such as myelodysplasia or bone marrow suppression caused by radiation therapy. Additionally, it can be caused temporarily by certain medications. Therefore, it is important to actively treat any underlying diseases causing the leukopenia.

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Written by Yang Li
Endocrinology
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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
Endocrinology
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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.

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How to treat leukopenia?

The treatment plan for leukopenia primarily depends on the cause of the decreased white blood cells. If the cause is related to blood cancer, further examinations like bone marrow biopsy are needed, followed by treatment of the primary disease. The second most common scenario is liver cirrhosis, which can lead to a decrease in all three blood cell lines, causing reduction in white blood cells, platelets, and hemoglobin. In such cases, treatment options may include splenectomy or the use of oral medications that increase white blood cell count. However, these treatments only address the symptoms and not the root cause, which is liver cirrhosis, thus the primary disease still requires treatment. The third scenario involves severe bacterial and viral infections, where a decrease in white blood cells indicates a serious condition, necessitating further antiviral or anti-infection treatments. (Please follow the guidance of a professional physician for medication use, and do not self-medicate.)