Leukopenia

As leukopenia , completely leukopenia , (from ancient Greek λευκός leukós , German , white ' ; ancient Greek κύτος kytos , German , cavity, vessel, envelope' and ancient Greek πενία PENIA , German , poverty, lack ' ) is a pathological lack of white blood cells ( leukocytes ) in the blood . This means that there has been a decrease in the white blood cell count, in humans to below 4000 per microliter of blood. In most cases there is a decrease in neutrophil granulocytes (neutrophil granulocytopenia, also neutropenia ). A reduction in lymphocytes ( lymphopenia ), on the other hand, rarely leads to a reduced total leukocyte count. A particularly severe special form is agranulocytosis , in which almost no granulocytes can be found in the blood. If the leukocyte count is very low, the patient is exposed to an increased risk of infection. Reverse isolation may then be necessary. The opposite of leukopenia is leukocytosis .

Leukopenia occurs with fulminant infectious diseases such as typhoid , as massive amounts of leukocytes are consumed here. In the case of viral infections, the leukocytes are shifted to the vessel walls ("edge pool") and thus a reduction in these cells in the circulating blood. Even if the bone marrow is damaged by chemotherapy , toxic substances or radioactive radiation, the number of white blood cells is reduced. Leukopenias are also common in leukemia and aplastic anemia . In addition, leukopenia can occur due to the increased breakdown of white blood cells in the spleen in splenomegaly , liver cirrhosis or pathological immunological processes such as lupus erythematosus . A moderately reduced number of leukocytes occurs in the course of hypersensitivity reactions with the formation of antibodies against the granulocytes. Drugs such as non-steroidal anti-inflammatory drugs or organic substances such as benzene come into consideration.

It is possible to increase the white blood cell count with medication by administering haematopoietic growth factors such as the granulocyte colony-stimulating factor G-CSF . This can be produced recombinantly since 1986 and was used in the first clinical studies as early as 1987. A replacement of granulocytes by granulocyte transfusion is only possible at a few treatment centers and is not very effective, since the transfused granulocytes only have a very short lifespan. Before starting such treatment, compatibility with the red and white blood cells of the recipient should be checked. Due to the high donor exposure, granulocyte transfusions are only used for persistent severe neutropenias that do not respond to G-CSF.

Individual evidence

^ Robert F. Schmidt, Gerhard Thews: Physiologie des Menschen . Springer-Verlag, 27th edition 2013, ISBN 978-3-662-00485-2
↑ ^a ^b Klaus Dörner: Clinical chemistry and hematology . Georg Thieme Verlag, Stuttgart 2006, ISBN 978-3-13-129716-7 , p. 261.
^ Graham Molineux, Mary Ann Foote, Tara Arvedson: Twenty Years of G-CSF: Clinical and Nonclinical Discoveries . Springer Science & Business Media, 2012, pp. 16-18. ISBN 978-3-03480-217-8
↑ Volker Kiefel: Transfusion Medicine and Immunohematology: Basics - Therapy - Methodology . Springer-Verlag, 4th edition 2011, ISBN 978-3-642-12765-6 , p. 324.

[1] Robert F. Schmidt, Gerhard Thews: Physiologie des Menschen . Springer-Verlag, 27th edition 2013, ISBN 978-3-662-00485-2

[Dörner-2] Klaus Dörner: Clinical chemistry and hematology . Georg Thieme Verlag, Stuttgart 2006, ISBN 978-3-13-129716-7 , p. 261.

[3] Graham Molineux, Mary Ann Foote, Tara Arvedson: Twenty Years of G-CSF: Clinical and Nonclinical Discoveries . Springer Science & Business Media, 2012, pp. 16-18. ISBN 978-3-03480-217-8

[4] Volker Kiefel: Transfusion Medicine and Immunohematology: Basics - Therapy - Methodology . Springer-Verlag, 4th edition 2011, ISBN 978-3-642-12765-6 , p. 324.