Q: How to increase the TLC count of a woman, who is suffering from breast cancer and undergoing chemotherapy?

A:Patients of cancer frequently develop cytopaenias, a decrease in the production of one or more blood cell types. The primary disease itself and chemotherapy and/or radiotherapy used to treat cancer, all lead to this. It has become a norm now to place cancer patients receiving cytotoxic chemotherapy drugs on immunoprotective agents at the first sign of immune impairment. Bacterial and fungal infection is a considerable cause of death in cancer patients, and chemotherapy-related leukopaenia is associated with substantial febrile morbidity. Prophylactic haematopoietic growth factors are used to reduce the incidence of febrile leukopenia, by shortening the duration of neutropaenia. Depending on the type of cancer and the chemotherapy regimen that will be used, some of these agents may include either a granulocyte-colony stimulating factor drug (G-CSF) or a granulocyte macrophage-colony stimulating factor (GM-CSF). These drugs stimulate the production of T-lymphocytes, macrophages, and other immune cells that are valuable in preventing the toxic effects on the bone marrow during chemotherapy. They also enable chemotherapy to be given at a higher dose that may make it more effective. Stimulated macrophages are powerful tumour killers, as has been demonstrated by clinical studies using interleukin-2 and GM-CSF or G-CSF. In addition, colony growth factors are able to accelerate the regeneration of blood cells following chemotherapy. Current clinical experience with GM-CSF and G-CSF has shown that severe neutropaenia (immune impairment) due to chemotherapy drugs may be prevented or at least decelerated, thus reducing the number of severe infections. Reducing the number of potential pathogens by means of prophylactic antibiotics and anti-fungal agents also lowers the risk of febrile morbidity.