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Blood is made up of three basic types of cells:
Your body is constantly producing blood cells. Blood cells are made in the bone marrow, the spongy tissue inside your bones. They come from a type of cell called a stem cell. The stem cell divides in response to signals made by your body. It will either become a red blood cell, a white blood cell, or a platelet. These signals are called growth factors. Blood cells live for a specified time in your body. White blood cells live for a few hours to a few months. Red blood cells live for 120 days. Platelets live for five to nine days.
Chemotherapy affects rapidly growing cells more than slower growing cells. Some normal cells have a fast rate of growth. These include your blood cells. A side effect of chemotherapy may destroy young blood cells as they are growing. It can take anywhere from seven to 21 days for your blood cells to reach their lowest numbers.
Your nurse or doctor will tell you when your blood cells counts are expected to be low. This is called your nadir. You will have your blood tested periodically to see how many of each type of blood cell you have. This is called having your counts checked.
Rec blood cells are measured by values called hemoglobin (Hgb) and hematocrit (Hct). The normal value for hemoglobin is 14.0 to 18.0; hematocrit is 37 to 52. If your red blood cell count is low, you may feel more tired or short of breath than usual. This is called anemia. Your doctor may order a red blood cell transfusion for you. Sometimes your red blood cells may be low because of the disease itself. Your doctor may prescribe a growth factor called erythropoietin (EPO) to help increase your red blood cell counts.
One type of white blood cells are neutrophils. When neutrophils are low, this is called neutropenia. You may not see the usual signs of infection so review the signs of infection at the bottom of this page.
A normal white blood cell count is 4,000 to 10,000. Sometimes your doctor may order a growth factor called GM-CSF or G-CSF to help your white blood cells recover more rapidly. The neutrophils fight most common infections. For that reason, this portion of the white cell count is also monitored. This is called the Absolute Neutrophil Count (ANC).
A normal platelet count is 130,000 to 400,000. A platelet count below 50,000 may make you more at risk for bleeding. This is called thrombocytopenia. If your platelet count drops, your doctor may order a platelet transfusion for you.
Talk with your nurse or physician about avoiding crowds and public places such as shopping malls, airplanes, buses, trains, etc. You may need to wear a mask if your white blood count is very low.
Good hygiene is important. Shower or bathe daily and pat yourself dry. Wash hands often and well. Always wash them before eating and after using the bathroom.
Be sure to notify your nurse or doctor immediately if you have any abnormal bleeding. This includes nose bleeds, blood in urine or stool, dark tarry stools, bleeding gums or easy bruising.
Be sure to let your nurse or doctor know if you develop any of the following signs of an infection: