CLINICAL QUERIES; What's the significance of the ANC?
Julie Miller BSN, RN, CCRN
Puja Hazari BSN, RN

February 2012 
Volume 42  Number 2
Pages 68 - 68
  PDF Version Available!

My patient was admitted with chemotherapy-induced neutropenia. Why did the oncologist ask me for her absolute neutrophil count (ANC)?-P.G., N.J.Julie Miller, BSN, RN, CCRN, and Puja Hazari, BSN, RN, reply: The total number of circulating leukocytes, or white blood cells (WBCs), is differentiated according to five types: neutrophils, eosinophils, basophils, lymphocytes, and monocytes.1 Neutrophils are the most abundant leukocyte (50% to 70%) and are the body's primary defense against microbial invasion.1A patient with neutropenia, a reduction in circulating neutrophils, is at increased risk for serious infection. Neutrophils include immature stab or band cells (bands) and mature segmented cells (segs). To keep them straight, remember that the bands are the "babies" and the segmented cells are the "seniors."You can determine whether your patient is neutropenic by calculating the ANC based on the differential WBC count. To calculate your patient's ANC, determine the percentages of bands and

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