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Leukopenia Causes

By Dr Ananya Mandal, MD

Leukopenia refers to the decrease in the number of white blood cells (WBC) in blood. This may be caused due to certain medications, chemotherapy for cancer, radiation therapy for cancer, surgery, stem cell transplant, bone marrow transplant, steroids, cancer itself, some genetic conditions as well as autoimmune diseases. This is called immunosuppression as leukopenia leads to a weakened immunity.

Normal WBC counts

Leukopenia is caused due to decrease in number of WBCs, particularly neutrophils. For normal adult males the WBC counts range between 4500 and 11000 per cubic millimetre of blood. This is slightly higher in children.

Causes of Leukopenia

Leukopenia may be caused by various diseases and drugs. Some of these are outlined here:-

Bone marrow damage or suppression

This is caused due to exposure to certain chemicals or toxins, cancer chemotherapy, radiation therapy and certain drugs. These agents cause a decrease in production of all the cells of the bone marrow leading to leukopenia, anemia (low number of red blood cell production and platelets).

Bone marrow diseases

In these conditions the bone marrow does not produce sufficient WBCs or selectively produces excess of one type of WBCs leading to a lack of other types. The causes include myelodysplastic syndrome, leukemia, myeloproliferative syndrome, myelofibrosis (bone marrow replaced by fibrous tissues), vitamin B12 or folate deficiency etc.

Cancers that have spread to the bone marrow

Cancers when they have spread to the bone marrow may lead to leukopenia. This is seen in lymphomas and other cancers.

Autoimmune disorders

This occurs when the body fails to recognise its own cells and begins to attack them. In cases of leukopenia the body’s WBC’s are perceived as foreign and attacked. The condition is called lupus or Systemic lupus erythematosus (SLE).

Severe infections

Severe infections that deplete the body of WBCs may lead to leukopenia. This is called sepsis.

Diseases of the immune system

Diseases of the immune system, such as HIV, which destroy T lymphocytes

Hypersplenism

This is caused by enlargement of spleen that destroys the blood cells leading to leukopenia as well as anemia.

Other conditions

Other conditions like thyroid disorders (particularly over active thyroid glands), aplastic anemia, rheumatoid arthritis, parasitic infestations, vitamin deficiencies, mineral deficiencies of copper and zinc typhoid, malaria, influenza, dengue, Rickettsial infections, tuberculosis etc.

Pseudoleukopenia

This occurs at the initial phases of the infection. The leukocytes (predominately neutrophils) are responsible for the initial reaction to an infection. After an infection these cells gather around the margins of the blood vessels (marginalized) so that they can scan for the site of infection. Thus there is increased WBC production but it appears low from a blood sample, since the blood sample is of core blood and does not include the WBCs gathered to reach the site of infection.

Drugs causing leukopenia

Some drugs may lead to leukopenia. Medications which can cause leukopenia include:

  • clozapine, an antipsychotic medication
  • sodium valproate and lamotrigine - antiepileptic agents
  • immunosuppressive drugs, such as sirolimus, mycophenolate mofetil, tacrolimus, and cyclosporine that are used in transplant patients
  • interferons used in treatment of multiple sclerosis etc.

The antidepressant and smoking addiction treatment medication called Bupropion and antibiotic Minocycline and penicillin may also cause leukopenia.

The mechanism of leukopenia caused by drugs is mainly mediated by the immune system itself. Some agents like cancer chemotherapy drugs however cause leukopenia by suppressing the bone marrow.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Apr 6, 2013

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Comments
  1. Rebecca Perez Rebecca Perez United States says:

    I have leukopenia and have had it for a long time now, I am tired now of feeling sick all the time! I pray to god they find a medication soon to heal me and so many others.
    I pray for the doctors to never stop trying to find the answer to this illness. GOD BLESS AND HELP YOU DOCTORS AND THANK YOU FOR TRYING!

    • Sally Wood Sally Wood United States says:

      I was feeling very sick and tired all the time for several years...I have COPD so my family doctor just chalked it up to that, even tho my blood work showed very low white count.....now she sent me papers to sign....and as I read them, noticed she has written down, "Leukopenia" as one of my chronic conditions....I am not pleased since I had researched tiredness etc and told her I thought I had it but she at that time, asked me what Leukopenia was and then just brushed it off. I am not fond of doctors having so many errors with them these past 15 years ......I am not sure how to approach her on this subject but really feel she has not been fair and honest with me so I have every right to find another Dr who is educated and knows what they are doing.....many seem to book two patients at a time......it's more about their bank accounts, then properly treating patients.

      • Rick Ridgeway Rick Ridgeway United States says:

        Sally, I discovered I had leukopenia in 2012 by accident. My doctor hid the facts from me. They overdosed me on tc99 and other drugs. My records show copd also,never got meds for it. I also have bradycardia, arrhythmia and nodules on my lungs. They experimented on me. Rick

  2. Rebecca Perez Rebecca Perez United States says:

    TOO ALL THAT HAVE THIS ILLNESS......NEVER GIVE UP AND KEEP ALL DOCTORS IN PRAYERS!! They are the key to all the illness out there, thank you doctors for all hard work you all put in to helping us sick people...your always in our prayers.

  3. Laura Frick Laura Frick United States says:

    I take Copaxone now 3x a week shots. Site soreness wi lump..- low White blood count high Red Blood count..So, how fast has people experienced worsening of MS milan degeneration with not taking Copaxone ?

  4. Dawn Lasalle Dawn Lasalle United States says:

    Hi Rebecca maybe you can help me..The doctor said I have Leukopenia..I had to go to the hospital cause I keep getting pains in my stomach and another doctor at my doctor's office seen this and was concerned...I told her they told me before my white blood count was low and did nothing and I kept telling them I am so tired and I keep waking up in the sweats and I am not menopausal..There checking me for leukemia cause my grandpop had it but then I have to see a Hematology ..Also my iga is low but that has to do with my sinus's can you tell me more about Leukopenia..Like what affects does it have to us when we have it? Are we tired? Does it cause fatigue..? can we get sick quicker then others?

    • Kathy Mcman Kathy Mcman United States says:

      Hi Dawn, I just came across your post. I have been seeing a Hematologist for a little over a year now, it's the best thing you can do. My primary referred me as my blood work came back saying that my WBC was a 3. I got blood work done every month, every other month to 6 months in between now. The tested me for everything under the sun, from anemia, Hiv, Lymphoma, Leukemia, and other blood disorders. All other test keep coming up negative so I am classified as having Leukopenia. Having  Leukopenia is having a consistent low WBC. Yes we are always tired (this was my main complaint to the doctor before he ordered my blood work) and Yes, your immune system is weakened (I've been fighting a cold/allergies for 3 months now, ugh!). I am 45 yrs old, eat healthy and exercise regularly and I'm still tired all of the time. I started some natural remedies to help boost my WBC. I will find out if they are working and report back when I get my next blood work done in March. I wish I had an answer to why I have Leukopenia, I hate the unknown, but Hopefully they will find something soon. I hope that you find your answers and pray that it's nothing serious that's  causing your leukopenia. Best reqards. Kathy

      • Dawn Dennis Snow Dawn Dennis Snow United States says:

        Hi Dawn, sorry you too are dealing with leukopenia!
        Kathy, you sound just like me! I'm currently using Moringa & some essential oils to hopefully improve my WBC. I go back this month & am excited to see if there is any change.
        Hang in there ladies, Dawn

  5. hilary thomas hilary thomas United Kingdom says:

    I am now suffering with my third bout of flu since let October and exhausted as I am working full time.  I find that I am tired constantly and despite trying to kept fit it has simply made me even more tired.  I am due to see a doctor today but unsure what help he can give other than take me off the Tegretol , I doubt that this will happen though as I was told I would have to take this all my life.  I feel that I need to wear a mask around people with 'germs' because if they have a cold I get 'file' etc. Any ideas how I can fight this lack of immune to bugs? Thank u all

  6. hilary thomas hilary thomas United Kingdom says:

    'Flu' !

  7. Deborah Cash Deborah Cash United States says:

    My father had leukopenia and thrombocytopenia which turn into leukemia he was tired and pains joints hurt for about 4 years we tried to find out what was going on with him and his blood work and he was at one time in the Army and then he works for a Atomic plant  he was around radiation now find out  that my brother  work in Atomic plant for 3 or more years lots of  people in these area have problem radiation ]has the same thing and he's in pain there's about 10 states that have the atomic plants in there that causes disease illnesses you have to check into. What causes Leukemia is in the water  in the air kidney failure stillborn deaths of leukemia cancer several different types of cancers they're not making you aware of My dad was  working in the 1960 at Atomic radiation plant they didn't  have the protective gear like they have now they were exposed to a lot of Bellevue radiation iron different types of radiation that they shouldn't be exposed to. My grandfather work out there and couldn't  take a bath befor coming out ofbthe plant and he had all thst radiation on his pants and my mom and her sister were little kids and when my grandfather would come home and wrap them around legs my mother has chemical burns all on her arms and legs which she grabbed my grandfather's pants leg they had to take her to Washington and Chicago two Specialists and they confirmed they were radiation Burns her sister has a lot of immune diseases from it also check into it in this area that I live most people get their blood drawn forearm radiation a lot of other things because of the radiation is in everything 60 minutes had a special on the town with the radiation plants and its effect.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
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