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How is neutropenia defined?
The white blood cell count (WBC) is the number of white blood cells in a
volume of blood. The normal range for the WBC varies slightly among laboratories
but is generally between 4,300 and 10,800 cells per microliter or cubic
millimeter (cmm). The WBC can also be referred to as the leukocyte count and can
be expressed in international units as 4.3 x 109to 10.8 x 109 cells per liter.
The percentage of the different types of white blood cells in the WBC is called
the WBC differential.
The absolute neutrophil count (ANC) is determined by the product of the white
blood cell count (WBC) and the fraction of neutrophils among the white blood
cells as determined by the WBC differential analysis. For example, if the WBC is
10,000 per microliter and 70% are neutrophils, the ANC would be 7,000 per
An ANC of less than 1500 per microliter (1500/microL) is the generally
accepted definition of neutropenia. Neutropenia is sometimes further classified
mild if the ANC ranges from 1000-1500/microL,
moderate with an ANC of
severe if the ANC is below 500/microL.
Some medical terms may be used synonymously with neutropenia, even though
their precise definitions are different.
Leukopenia refers to
a reduced number of white blood cells in general, while granulocytopenia refers to a decreased
number of all the granulocyte-type blood cells (neutrophils, eosinophils, and
Since neutrophils normally far outnumber the other types of
granulocytes, this term is sometimes used to refer to neutropenia.
Finally, agranulocytosis literally refers to a complete absence of all granulocytes, but
this term is sometimes used to refer to severe neutropenia.