What Is Leukopenia?

Leukopenia refers to a continuous leukocyte count in the peripheral blood of <4.0 × 10 ^ 9 / L, which is a common hematological disease. The onset of the disease is slow and the symptoms are mild. It is usually manifested by weakness, palpitations, dizziness, limb weakness, insomnia, and more dreams. When the white blood cell count is less than 2.0 × 10 ^ 9 / L and the absolute value of neutrophils is less than 0.5 × 10 ^ 9 / L, the symptoms are sudden headache, joint pain, extreme fatigue, etc. In severe cases, symptoms such as dysphagia may occur. The mortality rate is extremely high. When clinical medicine is used to screen for leukopenia, blood routine leukocyte-related parameters can also be used for screening. Blood routine results showed that the total number of white blood cells was (2.0 ~ 4.0) × 10 ^ 9 / L, and neutrophils also decreased. When the number of granulocytes was insufficient, the white blood cell count was less than 2.0 × 10 ^ 9 / L, and the number of granulocytes was significantly reduced. Even complete disappearance indicates a tendency to leukopenia.

He Guangsheng

(Deputy Chief Physician)

Department of Hematology, the First Affiliated Hospital of Soochow University

Leukopenia refers to a continuous leukocyte count in the peripheral blood of <4.0 × 10 ^ 9 / L, which is a common hematological disease. The onset of the disease is slow and the symptoms are mild. It is usually manifested by weakness, palpitations, dizziness, limb weakness, insomnia, and more dreams. When the white blood cell count is less than 2.0 × 10 ^ 9 / L and the absolute value of neutrophils is less than 0.5 × 10 ^ 9 / L, the symptoms are sudden headache, joint pain, extreme fatigue, etc. In severe cases, symptoms such as dysphagia may occur. The mortality rate is extremely high. When clinical medicine is used to screen for leukopenia, blood routine leukocyte-related parameters can also be used for screening. Blood routine results showed that the total number of white blood cells was (2.0 ~ 4.0) × 10 ^ 9 / L, and neutrophils also decreased. When the number of granulocytes was insufficient, the white blood cell count was less than 2.0 × 10 ^ 9 / L, and the number of granulocytes was significantly reduced. Even complete disappearance indicates a tendency to leukopenia.

Western Medicine Name

Leukopenia

English name

leukopenia

Affiliated Department

Internal Medicine-Hematology

The main symptoms

Infection, fatigue, weakness, etc.

Main cause

Cytotoxic drugs, chemical poisons, ionizing radiation, vitamin B12, folic acid deficiency or metabolic disorders, acute leukemia, etc.

Causes of leukopenia and common diseases

Data from patients with leukopenia from July 2015 to July 2016 were collected from the information management system (HIS) of Beijing Yangyangliu Hospital affiliated to Tsinghua University. Retrospective analysis was performed by age, gender, department distribution, and main symptoms. . Results There were 3344 leukocytopenia patients in 27046 routine blood tests, and the incidence was 12.36%.

Leukocytes play a major role in the five classifications of leukocytes. Therefore, in the patients with leukopenia studied, most of them had agranulocytosis (96.81%), and agranulocytosis was also visible (only 3.19%). Leukopenia and agranulocytosis occur in female patients. The proportion of female patients is much higher than that of male patients. This is related to the fact that women are more prone to immune system diseases than men. Immune system diseases can destroy white blood cells and cause white blood cell counts. Below normal.

There are many possible causes of leukopenia, including bacterial and viral infections, medicinal factors (such as chemotherapy drugs and antithyroid drugs such as propylthiouracil), connective tissue diseases (systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome) Etc.), diseases of the digestive system (cirrhosis, hypersplenism, hepatitis, etc.), and diseases of the blood system (malignant hematopathy, aplastic anemia, megaloblastic anemia, paroxysmal nocturnal hemoglobinuria, etc.). In recent years, with the change of people's diet and living habits, the pollution of air and water quality has increased, the incidence of leukocytopenia has gradually increased, and it has attracted more and more attention from clinicians.

Leukopenia is particularly common during tumor chemotherapy. The main pathogenesis is due to the lack of specificity of antitumor drugs. While killing tumor cells, it also causes severe damage to normal cells, especially proliferating bone marrow hematopoietic cells, leading to blood cell decline. . Clinically, due to the reduction of leukocytes, secondary serious infections and other factors affect the smooth progress of chemotherapy, which leads to a decrease in clinical efficacy and patients' quality of life. Therefore, to prevent and reduce bone marrow suppression after chemotherapy, promote bone marrow hematopoietic function recovery, and increase peripheral blood white blood cells. Has become the key to ensure the successful completion of chemotherapy and improve clinical efficacy.

Studies have shown that among the diseases that cause leukopenia, hematological diseases occupy a major position, including various types of benign blood diseases (such as megaloblastic anemia, paroxysmal nocturnal hemoglobinuria, etc.) and malignant blood diseases (such as leukemia, Lymphoma, Myelodysplastic Syndrome, Myeloproliferative Disease, etc.), the causes are also various. On the one hand, the granulocytic hematopoiesis may cause the reduction of peripheral blood leukocytes; Hematopoietic can also cause leukopenia. In general, diseases such as lung infections in respiratory diseases can cause increased white blood cells, and white blood cell elevation has been used as an infection-related indicator in clinical practice, but severe infections or viral infections, tuberculosis, and interpulmonary diseases are often seen in clinical work. Leukopenia is caused by diseases such as fibrosis. Therefore, not only should the leukopenia be increased in clinical diagnosis, but also whether patients with leukopenia have corresponding respiratory diseases.

Leukopenia differential diagnosis

Meet the diagnostic criteria for leukocytopenia, agranulocytosis, and agranulocytosis in the "Diagnosis and Efficacy Criteria for Hematological Diseases". Leukopenia: white blood cell count is less than 4 × 10 ⁹ / L; granulocytopenia: neutrophil count is less than 2 × 10 ⁹ / L; granulocytosis: neutrophil count is less than 0.5 × 10 ⁹ / L.

Leukopenia test

Routine blood test is one of the most commonly used methods in clinical laboratory medicine, and it is widely used in clinical examination. It mainly includes white blood cell count, red blood cell count, hemoglobin content, platelet count, etc. Routine blood test is used for disease screening, diagnosis, and diagnosis. The treatment evaluation has important clinical significance, and has now become a routine admission check-up and health examination program in most hospitals.

Leukopenia treatment principles

1. The active part of vitamin B4 nucleic acid is an essential component of leukocyte metabolism, which promotes cell growth, especially cell proliferation; vitamin B6 participates in amino acid and fat metabolism and stimulates the production of leukocytes, so it can be used to treat leukopenia .

2. Lixuesheng can promote cell redox. It was earlier used in the treatment of increasing white blood cells to prevent and treat leukopenia caused by various reasons. However, some scholars believe that the use of Lixuesheng alone to treat leukopenia has been reduced. Slow effect, small increase in white blood cells, lack of positive effect.

3. Cytokine therapy In the case of repeated infections and difficult to control, you can add subcutaneous injection of granulocyte colony stimulating factor (G-CSF), or granulocyte / macrophage colony stimulating factor (GM) on the basis of anti-infection. -CSF) subcutaneously. The above medications gradually reduce to disable the white blood cells and granulocytes after normal, and have the effect of increasing white blood cells, but this drug has obvious limitations: it is expensive and cannot be widely used in clinical practice; the effect is unstable and often accompanied by There are adverse reactions such as fever and allergies; some patients have poor results.