Absolute Neutrophil Count (ANC)

Absolute neutrophil count, or ANC, may decrease during cancer therapy.


Neutrophils are white blood cells that are important in fighting infection. ANC stands for absolute neutrophil count, and neutrophils may be down for a number of reasons.  A drop in the ANC may occur as a result of cancer chemotherapy.

Your absolute neutrophil count can be calculated using a common blood test called the complete blood count, or CBC. The CBC gives your doctor all of your numbers for red blood cells, white blood cells and platelets -- the small bits of cellular material that help to control bleeding.

The ANC is found by multiplying the total white blood cell count by the percent that are neutrophils.


Neutrophils are white blood cells that are numerous in the blood stream of healthy individuals and important in fighting infection. They typically constitute more than 50 percent of your total white blood cells when you are healthy. The presence of abnormally small numbers of neutrophils in the circulating blood is called neutropenia.

The bone marrow normally makes your blood cells, including neutrophils. Life-saving cancer therapies including chemotherapy and radiation may target rapidly growing cells and adversely impact the production of neutrophils -- and so a drop in ANC is sometimes an expected side effect.

According to the American Cancer Society, a healthy person has an ANC between 2,500 and 6,000.  When the ANC drops below 1,000, there may be some increased risk of infection, so your doctor will keep an eye on your counts very closely; you are at much greater risk of infection when the ANC is below 500.

In some cases, when ANC is expected to become low, or when it is already low, antibiotics and/or growth factors -- medicines that help boost your neutrophil production -- may be administered.


Hematology: Clinical Principles and Applications; Bernadette F. Rodak, George A. Fritsma, Elaine Keohane.

Elsevier Health Sciences, Dec 27, 2013.

American Cancer Society. Understanding Your Lab Results. Accessed October 2015.

National Comprehensive Cancer Network (NCCN). Myeloid growth factors. Version 1.2015.

Burris HA, III, Belani CP, et al. Pegfilgrastim on the same day versus next day of chemotherapy in patients with breast cancer, non-small-cell lung cancer, ovarian cancer, and non-Hodgkin's lymphoma: results of four multicenter, double-blind, randomized phase II studies. J Oncol Pract. 2010;6:133-140.

Updated November 2015.

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