Can leukopenia be a sign of cancer?

Yes. In general, leukopenia is not usually the first sign of cancer, but it can be. Leukopenia can occur due to blood cancer or as a side effect of cancer treatment. However, if you have leukopenia, it’s important for you to know that there are many causes, and it doesn’t mean that you have cancer.

Can leukopenia resolve without treatment?

Sometimes. Usually, leukopenia is not a normal condition, and it doesn’t typically get better on its own unless it’s a medication side effect. When you stop taking the medication, your white blood cells should begin to reach normal levels within a few weeks. If you are diagnosed with leukopenia, it’s important that your healthcare providers look for the underlying cause and start a treatment plan.

Is AIDS a type of leukopenia?

The human immunodeficiency virus attacks the T lymphocytes, which are a specialized type of leukocyte. AIDS is a health condition that can cause a low T cell count, which impairs the immune system. AIDS doesn’t always cause leukopenia, and it can be treated to maintain a healthy T cell count.

Leukopenia

By

Heidi Moawad, MD

Published on April 15, 2022

Medically reviewed by

Steffini Stalos, DO

Leukopenia is a low white blood cell (leukocyte) count that indicates a decrease in disease-fighting cells in your body. Leukopenia can indicate a variety of health complications, including serious infections, diseases, and cancer. Leukopenia can involve one or more types of white blood cells and may include neutropenia, monocytopenia, and more.

This article discusses conditions that may present as leukopenia, as well as causes, tests, treatment, and when to see a healthcare provider.

Person with hair loss from chemotherapy. Leukopenia may be seen in chemotherapy for cancer — Jasmin Merdan / Getty Images

Symptoms of Leukopenia

Leukopenia may not present with any symptoms. However, underlying conditions that can cause leukopenia can be severe.

Furthermore, if you don't have enough leukocytes, medical problems can worsen and infections can cause substantial harm to the body.

Symptoms of conditions associated with leukopenia include:

Fever, chills, sweats
Sore throat, congestion
Fatigue
Sores that take longer than usual to heal
Infected wounds
Loss of appetite, nausea, vomiting, diarrhea
Weight loss
Enlarged lymph nodes
Enlarged liver or spleen
Mucosal bleeding and small bruises on the skin

While some infections can improve on their own, persistent leukopenia (specifically, neutropenia), can permit infections to recur and be prolonged and severe, which would require treatment. Other underlying conditions, such as cancer, can progress into potentially life-threatening conditions.

Causes of Leukopenia

Health problems that destroy leukocytes or diminish leukocyte production can cause leukopenia.

Common causes of leukopenia include:

Medications, especially immunosuppressants and cancer therapies
Bone marrow disorders, including bone marrow cancer
Infections that consume or attack white blood cells, such as human immunodeficiency virus (HIV) or AIDS
Malnutrition

What Medications Cause Leukopenia

Many different medications can cause leukopenia as a side effect. For example, chemotherapy medications for people with cancer may exacerbate (worsen) leukopenia. Immunosuppressants may also cause leukopenia.

Many other categories of over-the-counter (OTC) and prescription treatments can also cause leukopenia. However, not everybody who takes these medications will experience leukopenia.

Some medications that can cause a specific type of leukopenia called neutropenia include the following:

Phenothiazine
Antithyroid drugs (thiouracil and propylthiouracil)
Aminopyrine
Chloramphenicol
Sulfonamides

Leukopenia caused by medication should resolve shortly after the medication is discontinued, but sometimes other measures are needed if the resolution is taking too long.

How to Treat Leukopenia

Treatment will aim to manage symptoms as well as resolve the underlying cause and prevent persistent or recurring symptoms.

Symptomatic treatment can include:

Fever: Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)
Bacterial infections: Antibiotics
Fungal infections: Antifungal medications
Viral infections: Can be treated with supportive care (fluids, fever reduction) and sometimes with antiviral therapy
Cancer: Chemotherapy, radiation treatment, targeted therapies, immunotherapy, or surgery
Injuries: Keeping wounds clean and getting medical attention for injuries

All of these strategies can help reduce the effects of underlying conditions associated with leukopenia.

Prevention of infections is also important and includes handwashing, avoiding undercooked or potentially contaminated food, avoiding contact with people who have a contagious infection, and staying updated on recommended vaccinations.

Additionally, a 2022 study supports the use of Neupogen (filgrastim) and Neulasta (pegfilgrastim) in helping patients get relief against severe chemotherapy-induced neutropenia.

Are There Tests to Diagnose the Cause of Leukopenia?

If you have leukopenia, it’s important to determine why you have developed this problem. Your complete blood count (CBC) will provide information about your total number of leukocytes and the percentage and number of each individual type. This will help your healthcare providers get an idea about the possible cause.

Neutrophils are the most common type of leukocytes. In fact, sometimes neutropenia is referred to as leukopenia because a low neutrophil count usually causes a low total leukocyte count.

Standard leukocyte values in a blood sample
Type of Cell	Number per cubic millimeter	Percentage of total leukocytes
Total leukocytes	5,000–10,000	100
Lymphocytes (B cells and T cells)	1,000–4,000	20–40
Segmented neutrophils	2,500–6,000	40–60
Band neutrophils	0–500	0–5
Eosinophils	50–300	1–3
Basophils	0–100	0–1
Monocytes	200–800	4–8

You may already know that you are at risk if you’ve been taking a medication that causes leukopenia or if you have been diagnosed with HIV, cancer, or a bone marrow disorder. You might need tests to follow the progress of your condition—such as a viral load (the amount of virus detectable in your body) if you have HIV.

If the cause of your leukopenia is not known, you may need tests to determine the cause, which can indicate which type of leukocytes are affected and your risk factors.

Tests you may need include:

A stool test to identify digestive malabsorption
Peripheral blood smear to identify abnormal blood cells
HIV test
Bone marrow biopsy if there is concern about possible blood cancer
Lymph node biopsy if there is concern about possible cancer in the lymph node

When to See a Healthcare Provider

Leukopenia can put you at risk for dangerous infections. You can also develop serious medical problems due to the underlying condition associated with leukopenia.

If you have been diagnosed with leukopenia, you may need to have periodic blood tests to monitor your white blood cell count. Your healthcare providers can also tell you what signs to look for that could indicate a medical complication.

Get medical attention if you experience any of the following:

High fever of 102 degrees Fahrenheit or above
Severe or persistent chills or sweats
Difficulty breathing
A sore that becomes red, painful, or filled with pus
Confusion, neck stiffness, vision changes
Severe vomiting or diarrhea or signs of dehydration (weakness, dizziness, deceased urination, dry skin)
Change in consciousnesses

Symptoms may not be present with leukopenia or, if present, they may be nonspecific and evolve quickly into something more serious.

Summary

Leukopenia is a low white blood cell count. This condition may accompany underlying diseases and lead to complications, such as infections. Common causes of leukopenia are medications (especially chemotherapy), bone marrow disorders, blood cancer, and some infections.

If you have leukopenia, it’s important to seek medical care to clarify the cause and treatment. Usually, identifying the underlying cause involves diagnostic testing before a treatment plan can be started.

A Word From Verywell

If you have been told that you have leukopenia, you may become very concerned when you begin to learn about the possible causes. However, it’s important for you to know that many of the causes of leukopenia are not life-threatening and can be treated with medication. With treatment, your leukocytes can return to healthy levels and the risks of leukopenia can resolve as well.

Frequently Asked Questions

Can leukopenia be a sign of cancer?

Yes. In general, leukopenia is not usually the first sign of cancer, but it can be. Leukopenia can occur due to blood cancer or as a side effect of cancer treatment. However, if you have leukopenia, it’s important for you to know that there are many causes, and it doesn’t mean that you have cancer.

Learn More: Leukocytes and Cancer
Can leukopenia resolve without treatment?

Sometimes. Usually, leukopenia is not a normal condition, and it doesn’t typically get better on its own unless it’s a medication side effect. When you stop taking the medication, your white blood cells should begin to reach normal levels within a few weeks.
If you are diagnosed with leukopenia, it’s important that your healthcare providers look for the underlying cause and start a treatment plan.
Is AIDS a type of leukopenia?

The human immunodeficiency virus attacks the T lymphocytes, which are a specialized type of leukocyte. AIDS is a health condition that can cause a low T cell count, which impairs the immune system. AIDS doesn’t always cause leukopenia, and it can be treated to maintain a healthy T cell count.

Learn More: HIV and AIDS

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