What is Leukopenia: Causes, Symptoms, Medicine, Treatment and Cost

Medicines

Since leukopenia exaggeratedly increases the risk of bacterial and viral infections, patients who experience an alteration in their leukocyte count, even a sensitive one, should pay particular attention to primary prevention from infectious diseases by periodically undergoing specific vaccinations. All patients suffering from leukopenia should also take care of their personal and hand hygiene, wear a mask to protect themselves from pathogenic insults and not get close to sick people.
Medical-pharmacological therapy is subordinate to the triggering etiopathological element; for example, in some cases, the plasma reduction of leukocytes is compromised by the administration of potent drugs; it can be deduced that suspending the drug and replacing it with a drug with similar activity reduces the symptoms, bringing the leukocyte count back to normal.
Generally speaking, a simultaneous bacterial infection is observed in patients suffering from leukopenia: for this reason, the administration of antibiotics is among the most effective therapies to ward off collateral symptoms. Only in extremely serious cases is it necessary to intervene with drugs to stimulate the synthesis of white blood cells and the administration of immunoglobulins (antibodies) derived from blood transfusions.
If the cause of the leukopenia depends on tumor or leukemia, the patient will have to follow one or more chemotherapy cycles.

Below are the classes of drugs most used in the therapy against leukopenia, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the patient’s state of health and his response to the treatment:

Antibiotic drugs for the treatment of infections in the context of leukopenia

In the context of leukopenia, the intake of broad-spectrum antibiotics in patients with high fever is essential; It is often preferable to administer these drugs intravenously even before identifying the specific pathogen. If the alteration in body temperature persists after the first 72 hours from the start of antibiotic therapy, in all likelihood, the leukopenia does NOT depend on bacterial infections; therefore, the patient must undergo further diagnostic tests.

Below are the most important antibiotic drugs and first-line medicinal specialties. The dosage cannot, however, be reported: it is up to the doctor to decide the optimal dosage for that patient, based on the triggering etiological agent; the same goes for the duration of therapy.

• Vancomycin (e.g. Zengac, Levovanox, Maxivanil), glycopeptide class
• Amphotericin B (e.g. Abelcet), polyene drug indicated for the treatment of fungal infections in the context of leukopenia
• Aciclovir (e.g. Aciclovir, Xerese, Zovirax): indicated for the treatment of leukopenia in the context of chickenpox or infections caused by the Herpes simplex virus
• Piperacillin (e.g. Limerik, Picillin, Ecosette): the drug is a semi-synthetic penicillin, with a broad spectrum of action, indicated for bacterial infections in the context of leukopenia
• Trimethoprim-sulfamethoxazole (e.g. Bactrim), sulphonamide antibiotic. The drug should be considered in therapy for the prevention of pneumonia in leukopenic patients who do NOT have fever. The drug appears to reduce the frequency of bacterial infections.

Drugs to reduce secondary symptoms of leukopenia

Oral canker sores and oropharyngeal ulcerations in general are very frequent in patients suffering from leukopenia. To relieve discomfort, it is recommended to take locally applied anesthetic drugs, topical corticosteroids and specific gargles. Below are some examples:

For further information and dosage: read the article on drugs for the treatment of oral canker sores

Medicines to rebalance the concentration of white blood cells in the blood

The administration of the drugs described below is indicated to treat the most common form of leukopenia (neutropenia), both in the chemotherapy-dependent variant and in that associated with HIV infections.

• Filgrastim (e.g. Zarzio, Tevagastrim, Filgrastim Hexal, Biograstim, Nivestim): for the treatment of the neutrophilic variant of leukopenia associated with chemotherapy treatments, it is recommended to start therapy with a dose of drug equal to 5 mcg/kg, subcutaneously or intravenously, once a day, for max. 2 weeks (until a neutrophil count of 10,000 units/microliter of blood is reached). Administer 24 hours after chemotherapy therapy. If necessary, increase the dose by 5 mcg/kg per day in case of no response after 5-7 days. For the treatment of leukopenia (var. neutrophilia) associated with AIDS, it is recommended to take the drug at a dose of 1-5 mcg/kg subcutaneously or intravenously, once a day. If no improvements are observed after 5-7 days, increase the dose by another 5 mcg/kg.
• Pegfilgrastim (e.g. Neulasta): the drug is used in therapy to reduce the duration of neutropenia and the incidence of its febrile variant. The drug is available in syringes and pre-filled pens (each dose consists of 6 mg of drug): administer the drug subcutaneously. Consult your doctor for more information.

Corticosteroid drugs: indicated for the treatment of leukopenia in patients with evident increase in cell turnover, an expression of autoimmune pathologies.

• Prednisone (e.g. Deltacortene, Lodotra): administered at a dose of 0.5-1 mg/kg per day (every other day), this drug appears to improve the white blood cell count (especially neutrophils) in patients suffering from leukopenia.