Absolute Neutrophil Count (ANC)
Calculate ANC from a CBC differential to assess infection risk and guide chemotherapy dosing decisions.
Results
What is it?
DISCLAIMER: For educational and reference purposes only. All clinical decisions must be made by qualified healthcare professionals. The Absolute Neutrophil Count (ANC) represents the actual number of neutrophil granulocytes in the blood and is the key measure of innate immune function. ANC = WBC x (% segs + % bands) / 100. It is measured in units of x10³/μL (thousands per microlitre), equivalent to cells/mm³. Normal ANC: 1.5-8.0 x10³/μL. Neutropenia classification: Mild 1.0-1.5; Moderate 0.5-1.0; Severe <0.5 (also reported as <500 cells/μL). Febrile neutropenia (ANC <1.0 x10³/μL with fever) is a medical emergency requiring prompt evaluation and antibiotics.
How to use
Enter the total WBC count and the percentage of segmented neutrophils and bands from the CBC differential report. ANC, an absolute value in x10³/μL, and a severity category are calculated. The ANC is used before each cycle of chemotherapy to determine whether treatment can proceed safely.
Example scenario
CBC shows: WBC 5.0 x10³/μL, 60% neutrophils, 5% bands. ANC = 5.0 x (60 + 5) / 100 = 5.0 x 0.65 = 3.25 x10³/μL — normal. After chemotherapy: WBC 1.5, 30% neutrophils, 5% bands. ANC = 1.5 x 0.35 = 0.53 x10³/μL — moderate neutropenia. The oncology team may hold or delay the next cycle.
Pro tip
Febrile neutropenia (ANC <1.0 and temperature >38.3°C or >38.0°C sustained) is treated as an oncologic emergency. Many cancer centres have standing protocols for empiric broad-spectrum antibiotics within 1 hour of presentation. G-CSF (filgrastim/pegfilgrastim) is used prophylactically or therapeutically to accelerate neutrophil recovery. Track ANC trends, not just single values.