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White blood cells are a component of the immune system whose main role is to fight infection within the body. They are divided into different cells according to their function. Neutrophils are the most numerous and important infection-fighting type of white blood cells. Neutrophils play a crucial role in immunity as they protect the body against infection by destroying bacteria, fungi, and foreign particles. Absolute Neutrophil Count (ANC) is a common blood test that quantifies the total number of neutrophils in a blood sample to monitor immune function and a patient’s risk of acute infection. ANC is critical in the treatment of immunocompromised patients.

What is an ANC blood test?

ANC can be measured during a routine complete blood count (CBC) test. CBC is a common blood test that calculates the number of red blood cells, white blood cells, and platelets in a blood sample. ANC is used to monitor infection, leukaemia, and other infections. Furthermore, it is a routine test in immunocompromised patients such as cancer patients receiving chemotherapy as ANC is the indicator that assesses their likelihood of contracting opportunistic infections.

How is ANC calculated?

The normal range for ANC in a healthy person is 2,500 and 7,000. ANC is not measured directly. Instead, its calculation involves multiplying the total white blood cell (WBC) count by the neutrophils percentage in a blood sample. Calculation of ANC considers the total number of white blood cells, the percentage of neutrophils, and the percentage of band cells in a blood sample at a given time.

An example of ANC calculation:

A patient has a total WBC count of 10,000. The patient’s neutrophil differential count is 50%, meaning 50% of all white blood cells are neutrophils. Multiply the total WBC count by neutrophil percentage in the differential WBC count to calculate ANC. If the total WBC count is 10,000 and the neutrophil percentage is 50%, then ANC is 5,000. (10,000 x 0.50 = 5,000)

The process of calculating ANC is now automated. Modern laboratory tools can automatically compute the number of each type of white blood cell and measure the ANC. Previously, lab technicians manually tallied the different cells using a microscope. After finding the ANC in a blood sample, interpretation of the results follows. The interpretation of ANC tests classifies the results into low, high, and normal.

What does it mean if ANC is high?

1. High ANC levels indicate neutrophilia, caused by an increase in neutrophil count. Neutrophilia is diagnosed when ANC is above 7,500. A variety of problems can cause an increased neutrophil count.
2. Causes of neutrophilia are blood disorders, stress, common infections, inflammation, and smoking. Many medical professionals consider an increase in the neutrophil count to be the body’s reaction to an internal or external factor. Symptoms of neutrophilia include weakness, dizziness, recurring infections, painful joints, and a body temperature above 38 degrees Celcius (100.4 degrees Fahrenheit).
3. Neutrophilia is a sign of an underlying condition. Therefore, there is no treatment, and the patient’s outcome depends on the underlying condition. However, there are measures individuals can take to prevent neutrophilia. These include maintaining a healthy weight, managing stress, and quitting smoking. Patients with neutrophilia are advised to contact healthcare providers concerning their symptoms.

What does it mean if ANC is low?

1. Low ANC levels indicate neutropenia characterized by a decrease in neutrophil count. Neutropenia is a serious condition that increases a patient’s vulnerability to infection. Therefore, the lower the ANC, the higher the risk of infection. Medical practitioners work out a diagnosis of neutropenia if ANC is below 1,500.
2. Neutropenia is mainly caused by infection and is very common in cancer patients receiving chemotherapy. Its causes encompass infections such as hepatitis, TB, sepsis, some medications, cancer, blood disorders, vitamin deficiencies such as vitamin B12, and autoimmune diseases such as Crohn’s disease and lupus. Neutropenia symptoms are mild and include fever, sores, swelling, and recurring infections.
3. In some cases of neutropenia, no treatment is given as the body has innate mechanisms that can naturally resolve the issue. However, doctors may prescribe medications to treat underlying infections and boost white blood cell production. A serious condition that requires treatment is febrile neutropenia. In this case, intravenous antibiotics are administered, and the patient is admitted.

Applications of ANC in diagnosis and treatment

ANC is a critical measurement employed in the treatment of cancer patients. These patients have a high risk of developing neutropenia due to chemotherapy. Therefore, they are vulnerable to contracting acute opportunistic infections. Neutropenia is particularly common in leukaemia patients as the bone marrow is destroyed, reducing the production of neutrophils.

Conclusion:

Neutrophils constitute 50 to 70 percent of the total white blood cell count. They have a major function in immunity and protect the body against bacterial infection. The number of neutrophils in the body may vary depending on various factors. These include infection, medication, injuries, stress, and congenital disorders. The variations in the number of neutrophils or absolute neutrophil count ANC results in neutrophilia and neutropenia. The importance of ANC in blood tests is evident in the diagnosis and treatment of numerous conditions. Furthermore, ANC forms the basis of our understanding of neutropenia, which affects immune function. Neutropenia is a life-threatening condition in immunocompromised patients.