Cancer patients often suffer from altered leukocyte values after radiation or chemotherapy . The treatment affects the production of white blood cells , causing them to fall in the blood.
The fewer of them there are, the greater the risk of infection , since the immune system only works reliably with the help of white blood cells. Therefore, in cancer patients, it is urgently necessary to check the leukocyte level in the blood before any treatment with cytostatics.
Altered leukocytes in cancer patients: why do you need chemotherapy and radiation?
Cancer patients with solid tumors usually have surgery to remove the cancerous growth. After that, you want to make sure that no tumor cells remain in the body, either as remnants of the primary tumor that the surgeon was unable to completely eliminate, or as secondary tumors (metastases) that detach from the original tumor and spread elsewhere in the body via the lymph and bloodstream have settled.
In the case of blood cancer (leukemia), surgical removal of the cancer is not possible because it is in liquid form and has spread throughout the body with the blood.
In both cases, an attempt is made to kill the cancer cells with chemotherapy and/or radiation. If this is not done, they can continue to grow and form new tumors and metastases or make the leukemia worse. In the first case one speaks of a recurrence . It often makes further treatment more difficult, because in many cases the metastases are genetically modified. This ensures that many of them can no longer be treated in the same way as the original primary tumor and new measures are required.
Key facts at a glance!
- In the case of cancer, an attempt is made to kill the cancer cells with cytostatic drugs or radiation.
- However, other fast-growing cells such as those in the bone marrow are also affected.
- This damage causes the production of leukocytes in a cancer patient to decrease.
- The result is an increased susceptibility to infections, since the white blood cells are responsible for fighting off viruses and bacteria.
- The blood values of the leukocytes must therefore be checked prior to chemotherapy so that the immune system does not collapse completely.
Why do leukocytes change in cancer patients?
Both chemotherapy with cytostatics and radiation primarily affect fast-growing cells. This is based on damage to the genetic material and similar mechanisms, so that they can no longer divide normally and die off. Cancer cells are particularly affected by this because, due to the lack of functioning control mechanisms, they grow unchecked and multiply much faster than their healthy predecessors.
However, chemotherapy and radiation do not stop at other fast-growing cells.
These include, for example, the cells of the skin and mucous membranes . Therefore, skin reactions occur during radiation and patients suffer from nausea, diarrhea and vomiting during chemotherapy, since the mucous membranes of the gastrointestinal tract are also affected.
The effects on the blood-forming system are even more serious. Altered leukocytes in cancer patients are due to the fact that chemo and radiation also affect the rapidly proliferating cells of the bone marrow . As a result, the number of red blood cells ( erythrocytes ), platelets (thrombocytes) and, above all, white blood cells (leukocytes) decreases. This condition is called leukopenia (lack of white blood cells).
Why are the altered leukocytes dangerous in cancer patients?
While a lack of red blood cells manifests itself as anemia and that of platelets as reduced blood clotting, the consequences for white blood cells are much more serious.
Leukocytes are the cellular components of the immune system , and some of them produce antibodies that kill viruses and bacteria.
Therefore, the decrease in these cells is fatal to the body. The fewer there are, the weaker the immune system becomes. The more it is affected, the easier it is for pathogens. The susceptibility to infections increases, and even a simple flu infection or a small skin wound can have fatal consequences.
Why check leukocytes in cancer patients
The possible complications of chemotherapy are even greater than usual when the white blood cells are already in the basement. If you go one step further and treat the body with cytostatics, the immune system may no longer be able to function properly and the patient may even die after a minor infection.
Therefore, before any chemotherapy, it is absolutely necessary to precisely analyze the composition of the blood and especially the leukocytes in cancer patients. This is done with the help of a complete blood count , which not only records the red and white blood cells and platelets in their entirety, but also differentiates between the different types of leukocytes such as monocytes , granulocytes and lymphocytes .
Depending on how this differential blood count turns out, the doctors responsible have to decide whether a new round of chemotherapy is possible or whether they have to wait until the number of leukocytes in the cancer patient has returned to normal to some extent.
Sources, links and further reading
- Gerd Herold: Internal Medicine. Cologne 2016: G. Herold-Verlag. ISBN-10: 3981466063
- Wolfgang Piper: Internal medicine. 2nd Edition. Stuttgart 2012: Springer Verlag. ISBN-10: 3642331076.
- Reinhard Andreesen, Hermann Heimpel: Clinical hematology. Munich 2009: Urban & Fischer/Elsevier-Verlag. ISBN-10: 343731498X.
- Marlies Michl: BASICS Hematology. Munich 2016: Urban & Fischer/Elsevier-Verlag. ISBN-10: 3437421697.
- Willibald Pschyrembel: Clinical Dictionary . 266th edition. Berlin 2014: Walter de Gruyter-Verlag. ISBN-10: 3110339978.
- Marlies Michl: BASICS Hematology. Munich 2016: Urban & Fischer/Elsevier-Verlag. ISBN-10: 3437421697.
- Kurt Possinger, Anne Constanze Regierer: Specialist knowledge in hematology and oncology. 3. Edition. Munich 2015: Urban & Fischer/Elsevier-Verlag. ISBN-10: 3437212133.
