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Febrile Neutropenia Overview

What is Neutropenia?

Neutrophils are a type of white blood cell. White blood cells are part of your immune system. Neutrophils play an important role in your body’s defense against infection. Cancer treatment, such as chemotherapy, can decrease your body’s number of neutrophils because chemotherapy kills both normal cells (such as immune cells) and abnormal cells (cancer).1,2,3  Neutropenia occurs when you have a lower than normal level of neutrophils.1,2 Unfortunately, 60,000 people with cancer are hospitalized due to neutropenia each year in the US.3

What is Febrile Neutropenia?

Febrile neutropenia is when significant neutropenia is accompanied by a fever. For most people with cancer, suffering from neutropenia is the greatest risk factor for getting a serious infection. These infections can become serious or life-threatening if not found and treated early.3 As a result of this, if you have a low neutrophil count, your cancer team may have to delay or discontinue your cancer treatment or reduce your dose to prevent worsening neutropenia.1,2,4

What are risk factors for Febrile Neutropenia?

Some factors that may increase your risk for Febrile Neutropenia caused by chemotherapy include:

  • 65 years of age or older
  • Other chronic diseases such as diabetes and heart disease
  • Underweight or poor nutrition
  • Difficulty doing basic physical activities like walking
  • Prior exposure to chemotherapy or radiation
  • Persistent low white blood cell count
  • Long-term weakened immune system due to infection, disease or immune-suppressing medications
  • Lung, kidney or liver disease
  • Recent surgery and/or open wound
  • Recent infection4,5

What are the symptoms of neutropenia?

Symptoms of neutropenia include fever, chills, mouth sores, cough, difficulty breathing and abdominal or rectal pain.2

How is Febrile Neutropenia treated?

Patients with febrile neutropenia should be promptly evaluated by a doctor.  Treatment of febrile neutropenia is usually done with intravenous (in the vein) antibiotics.  Patients are usually hospitalized to allow for close monitoring.1,2  The average hospital stay for febrile neutropenia is approximately 10 days.6

Can Febrile Neutropenia be prevented?

Giving an injection of a medication that stimulates the growth of neutrophils may reduce the incidence of febrile neutropenia.  It may shorten the number of days you have neutropenia, resulting in lower risk for febrile neutropenia.  These medications are called growth factors or colony-stimulating factors (CSFs).  Examples include filgrastim and pegfilgrastim.

Also, your cancer care team may choose to delay your cancer treatment to give your body enough time to make more white blood cells.1,2


  1. JAMA Oncol. 2017;3(12):1751. doi:10.1001/jamaoncol.2017.1114 Febrile Neutropenia | Oncology | JAMA Oncology | JAMA Network. Accessed December 8, 2022.
  2. Low White Blood Cell Counts (Neutropenia). American Cancer Society website. Updated February 1, 2020. Accessed December 8, 2022.
  3. Top 5 things to know about neutropenia. US Department of Health and Human Services Center for Disease Control and Prevention website. Accessed December 8, 2022.
  4. Crawford, J. Risk Assessment and Guidelines for First-Cycle Colony-Stimulating Factor Use in the Management of Chemotherapy-Induced Neutropenia. Oncology. 2006;20(5):Suppl4. PMID:16736985
  5. Lyman GH, Lyman CH, Agboola O. Risk models for predicting chemotherapy-induced neutropenia. Oncologist. 2005;10(6):427-437
  6. Tai E, Guy Jr GP, Dunbar A, Richardson LC. Cost of cancer-related neutropenia or fever hospitalizations, United States, 2012. J Oncol Pract. 2017;13(6):e552-e561. doi:10.1200/JOP.2016.019588