Treatment Side Effects - Low Blood Cell Counts

Reviewed by: HU Medical Review Board | Last reviewed: February 2018

Treatment for blood cancer can lower the number of blood cells in a person's body, causing anemia, neutropenia, or thrombocytopenia. Anemia is when the body does not have enough red blood cells. A lack of white blood cells is called neutropenia, and when there are not enough platelets, thrombocytopenia occurs. When all three types of blood cells are low, it is called pancytopenia.1,2

When the blood cells levels are low, a person can experience additional symptoms or complications, such as:

  • Symptoms of anemia (low red blood cells) may include fatigue, weakness, lightheadedness, shortness of breath, headache, cold hands or feet, fast or irregular heartbeat, pale skin, or chest pain2,3
  • Symptoms of neutropenia (low white blood cells) may include repeated infections, fevers, chills or sweating, mouth sores, skin sores, sore throat, or fatigue4
  • Symptoms of thrombocytopenia (low platelets) may include frequent bruises, prolonged bleeding from cuts, frequent nosebleeds, blood in urine or stool, heavier menstrual flows than usual, pain in the joints or muscles, headaches, fatigue, or small, pinhead-sized red spots on the skin, known as petechiae2,5

Why does blood cancer treatment cause low blood cell counts?

Chemotherapy targets rapidly dividing cells, which includes blood cancer cells but also can affect healthy blood cells in the bone marrow.1

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Stem cell transplants can affect a person's blood cells as they use high doses of chemotherapy to kill cancer cells. This destroys both healthy and cancerous blood cells and causes a severe weakening of the immune system until the replaced stem cells take effect.1

Targeted therapies may affect the platelets, causing an increased risk of bleeding or bruising.6

Managing low blood cell counts

In some cases, blood transfusions or medications may be given to boost a person's low blood cell counts. There are also lifestyle approaches that an individual can take, including:

  • To help boost red blood cells, eat foods that are high in iron (like red meat, beans, almonds, and broccoli) and foods high in folic acid (like asparagus, spinach, and lima beans)7
  • To help reduce the risk of bleeding from low platelets, use electric shavers rather than razors, avoid alcohol, wear shoes to protect feet, blow nose gently, use soft-bristled toothbrushes, avoid contact sports or rough activities, and don't pick at pimples or scabs2,8
  • To help reduce the risk of infection (due to low white blood cells), wash hands frequently and thoroughly, avoid contact with people who are sick, avoid crowds, and only eat food that has been properly cleaned and/or cooked2

In addition, some common medications like aspirin or other over-the-counter medications can also affect blood cells, and these side effects may be more significant during treatment for blood cancer. People undergoing treatment for blood cancer should talk to their doctor about all medications they are taking and whether it is safe to use over-the-counter medications.2