• ANC = (total WBC) x (%segs + %bands)
  • Nadir usually occurs 5-10d after chemo
  • Duration of neutropenia depends on type of cancer treatment
    • Solid tumor treatments: <5d
    • Hematologic malignancies: 14d or longer
  • (Leukemia or lymphoma) + chemo most commonly associated with neutropenia

Neutropenic fever definition

  • ANC <500 OR <1000 with predicted nadir of <500 in 48h AND
  • Fever ≥ 38.3˚C (100.9˚F) once OR sustained temperature ≥38 (100.4) for >1hr
    • Oral temperature (do not obtain rectal temp; risk of inducing bacteremia[1])

See Also

  1. Fleischman RJ. Emergency Complications of Malignancy. In: Cydulka RK, Fitch MT, Joing SA, Wang VJ, Cline DM, Ma O. eds. Tintinalli's Emergency Medicine Manual, 8e. McGraw-Hill; Accessed December 09, 2020.