How does the absolute neutrophil count change invasive dental planning for a child with leukemia?
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How does the absolute neutrophil count change invasive dental planning for a child with leukemia?
Obtain a current CBC with differential and platelets with oncology before invasive care; account for the expected nadir and procedure-related bleeding.
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Absolute neutrophil count (ANC)
Dental decision
> 2,000/mm³
No antibiotic prophylaxis is needed on the basis of ANC alone.
1,000–2,000/mm³
Individualize antibiotic coverage with oncology from health status, procedure, and infection at the treatment site.
< 1,000/mm³
Defer elective care. For an emergency, agree on antibiotics and setting with oncology; hospitalization may be needed.