Common Issues in Supportive Care: Part 2 – Low Blood Counts

Welcome to the second section of our three part blog series on common issues in supportive care. This segment will examine low blood counts. Be sure you talk regularly to your health care team—together, you can figure out the best management plan for you and, ideally, prevent these issues from developing.

Low blood counts

Another consequence of having myeloma cells in the bone marrow is a reduction in blood cell counts, including the red blood cells, white blood cells, and platelets.

Anemia, which is a low red blood cell count, is a common clinical feature of myeloma. It causes patients to have a number of side effects, chief of which is fatigue. Doctors can detect when your red blood cell count is low by measuring the levels of hemoglobin in the blood. Hemoglobin is carried by red blood cells; when you have fewer red blood cells, your hemoglobin value is lower. Hemoglobin carries oxygen to the body, and lack of oxygen makes you feel tired, weak, and sometimes short of breath or lightheaded. Many medications are available that can increase the number of red blood cells—these medications are called growth factors. When red blood cell counts get too low, a blood transfusion may be required.

A low white blood cell count is called leukopenia, and when the low count involves a specific type of white blood cell called a neutrophil (which is important in fighting off infections), the condition is called neutropenia. Having a reduced number of neutrophils in your body makes infections harder to fight off. Therefore, if you develop neutropenia, your doctor will want you to take particular care to follow standard infection precautions, such as regular hand-washing and avoiding large crowds. Getting vaccinated for flu and pneumonia is also important, as that reduces your chances of getting an infection or reduces the severity of the illness if you become infected. Checking for fevers is extremely important for patients who have neutropenia, because a fever is considered a medical emergency. You’ll need treatment right away, because you don’t have the cells to fight an infection! As with anemia, there are certain growth factors that can be given to boost the number of white cells in the body. Patients who have experienced serious recurrent infections may receive an intravenous antibody treatment. Because some myeloma drugs increase the risk of developing fungal infections or viral infections (like herpes), patients receiving these drugs may be prescribed antifungal or herpes-prevention drugs.

Part 3 – Kidney Disease, Nutrition & General Health
Part 1 – Bone Health

Nurse Patient Navigators in the MMRF Patient Support Center are always available at 888-841-6673 to help answer any questions you have or to help you find the right resources to help in your fight against myeloma.

Additional Resources

MMRF. How important is your nutrition in your battle with multiple myeloma?

MMRF. Symptoms, side effects, and complications.

MMRF. 2019 Patient Summits.

MMRF. MMRF Patient Toolkit. Multiple Myeloma Disease Overview.