A child with leukemia received chemotherapy three days ago. Which hematological laboratory value does the nurse expect?

A. Increased hemoglobin count is incorrect. Chemotherapy does not stimulate red blood cell production; in fact, it often leads to bone marrow suppression, which reduces the production of red blood cells. This can result in anemia over time, but hemoglobin levels would not increase three days post-chemotherapy. B. Decreased absolute neutrophil count is correct. Chemotherapy targets rapidly dividing cells, which includes both malignant leukemia cells and healthy bone marrow progenitor cells. This results in myelosuppression, with neutrophils being affected earliest due to their short lifespan (6–8 hours in circulation). Within a few days post-chemotherapy, children often develop neutropenia, which is reflected in a decreased absolute neutrophil count (ANC). Neutropenia increases infection risk, sometimes without obvious signs, because the immune system’s first line of defense is compromised. C. Decreased erythrocyte count is partially correct but less immediately expected. Red blood cells have a lifespan of approximately 120 days, so anemia typically develops gradually, rather than within the first few days post-chemotherapy. Significant decreases in hemoglobin are usually seen one to two weeks after treatment, unlike neutropenia which occurs sooner. D. Increased platelet count is incorrect. Chemotherapy generally causes thrombocytopenia, as platelet precursors in the bone marrow are also affected. This increases the risk for bleeding, bruising, and delayed clotting, rather than elevating platelet numbers.