Leukopenia (White Blood Cell Deficiency): What is it, its Symptoms, Causes, and Treatment?

White blood cells, also known as leukocytes, derive their name from the Latin words leucko (white) and cyte (cell). These cells play a crucial role in the immune system's response to both internal and external factors. A decrease in the number of these cells is referred to as leukopenia. White blood cells are classified into five main groups: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. These groups can be affected individually or separately depending on various diseases.

What is Leukopenia (White Blood Cell Deficiency)?

Leukopenia refers to the condition where the white blood cell (WBC) count is found to be below normal limits in a complete blood count test. This reduction in immune cells is significant as it may make the person more susceptible to infectious diseases.

In healthy individuals, the normal range of white blood cells is between 3,500-4,000 and 10,000-11,000 per microliter of blood. If the white blood cell count is found to be below 4,000, it may indicate the presence of leukopenia.

Although the terms leukopenia and neutropenia are sometimes used interchangeably, it is important to note that this is a misapplication. Leukopenia refers to a decrease in the total number of all white blood cells, while neutropenia specifically refers to a reduction in the number of neutrophils, which are the most abundant type of white blood cell.

Neutrophils make up approximately 55-70% of white blood cells. Their primary role is to combat bacterial and fungal infections. Following neutrophils, lymphocytes, which help defend the body against viruses, are the most common white blood cells in the blood. Basophils, the least abundant white blood cell group, are involved in the inflammatory response to allergens. Eosinophils are believed to play a role in allergic reactions and diseases like asthma. Monocytes, the largest defense cells, continue to fight bacteria, viruses, and fungi.

What are the Symptoms of Leukopenia (White Blood Cell Deficiency)?

White blood cells are produced in the bone marrow and are critical for the body's defense functions. A decrease in their number can negatively impact an individual's ability to fight diseases and microorganisms capable of causing illness, leading to various infection symptoms:

• Fever
• Sweating
• Chills and shivering

In addition to these common symptoms, the complaints that may arise from leukopenia can vary depending on the underlying cause and which specific group of white blood cells is affected.

What Causes Leukopenia (White Blood Cell Deficiency)?

Various health issues can cause leukopenia by either affecting the production of white blood cells in the bone marrow or accelerating their destruction:

Viral and Bacterial Infectious Diseases
A temporary state of leukopenia can occur during acute viral diseases, such as the common cold or flu. In the early stages after the virus enters the body, the process of white blood cell production in the bone marrow is negatively affected. Apart from these disorders, certain severe illnesses may increase the rate at which the body uses white blood cells. Viral infections like HIV can specifically target certain types of white blood cells, leading to the development of leukopenia.

Leukopenia can also occur in various bacterial infections. Tuberculosis, for example, is one of these conditions. Especially in women, after contracting this severe infection, there is an increased risk of developing leukopenia.

Bone Marrow Problems
Conditions like aplastic anemia, overactive spleen, and myelodysplastic syndrome can result in the development of leukopenia. The bone marrow, located in the center of the bones, is a spongy tissue responsible for producing blood cells. In addition to the aforementioned disorders, certain types of cancer, chemotherapy, radiation treatments, or exposure to chemicals like benzene and pesticides (agricultural chemicals) can adversely affect the bone marrow, leading to leukopenia.

Cancer
Various cancers, including leukemia, can damage the bone marrow, causing the development of leukopenia.

Autoimmune Disorders
Autoimmune disorders refer to the immune system’s attack on the body's own tissues and organs. Conditions such as rheumatoid arthritis and lupus can cause leukopenia if the white blood cells are targeted during the disease process.

Congenital Diseases
Congenital disorders, such as Kostmann syndrome, can lead to the development of leukopenia.

Nutritional Deficiencies (Malnutrition)
Vitamins and minerals are generally classified as micronutrients. Deficiencies in micronutrients, including vitamin B12, folate, copper, and zinc, can lead to leukopenia, so care should be taken.

Sarcoidosis
Sarcoidosis is a multisystemic disorder characterized by inflammatory formations called granulomas. With the immune system becoming overactive and causing severe inflammatory conditions in various parts of the body, this disease can also affect the bone marrow, leading to leukopenia.

In addition to these health issues, leukopenia may also develop as a result of the use of certain medications for the treatment of various disorders. Medications such as interferon-based drugs used in the treatment of multiple sclerosis (MS), some anticonvulsants, bupropion-based drugs used for smoking cessation and depression treatment, certain antipsychotics, steroid medications, and some antibiotics like penicillin can suppress the bone marrow and lead to the development of leukopenia. Therefore, it is crucial to avoid using medications without the knowledge and prescription of a healthcare provider.

How is Leukopenia (White Blood Cell Deficiency) Diagnosed?

The diagnosis of leukopenia is relatively simple and can be made by examining the levels of white blood cells through a complete blood count, which is a straightforward test.

How is Leukopenia (White Blood Cell Deficiency) Treated?

The treatment of leukopenia may vary depending on which type of immune cell is affected and the underlying cause of the condition. Several methods may be employed as part of the treatment approach for leukopenia:

Medication Treatment
In individuals with leukopenia, the use of various medications can help support the production of immune system cells in the body. If an infectious disease is identified as a factor in the development of leukopenia, antiviral, antifungal, or antibiotic medications may be prescribed to target the infectious agent.

In some cases, the underlying cause of leukopenia may be medications used for other health issues. In such cases, these medications can be replaced with alternatives that have a lower risk of causing this side effect, under the guidance and recommendation of a healthcare provider.

Use of Growth Factors
Various growth factors used to stimulate stem cells in the bone marrow and support the production of immune system cells from these cells can be particularly beneficial in cases of leukopenia caused by genetic disorders or chemotherapy. This treatment has been found to yield positive results in some cases.

Changes in Diet
In individuals with severe leukopenia, it is important to keep the bacterial level of the foods consumed low. Additionally, individuals with leukopenia should pay extra attention to the body's need for vitamins and minerals by maintaining a healthy and balanced diet.

In addition to changes in diet, methods such as resting, taking precautions against even minor cuts, and ensuring proper body hygiene after exposure to environments where potential infectious agents are present are practices that can help individuals with leukopenia avoid severe infections.

Considering all of these factors, it is recommended that individuals with leukopenia undergo regular check-ups and routine monitoring of their white blood cell levels.