CLL - FAQ

43. What is a neutropenic diet?

Neutrophils are an important defense against infection, especially bacterial infection. Treatment and disease progression can both compromise neutrophil counts. When neutrophil counts fall below 1000 (1.0 x 10⁹/L), patients are in jeopardy of infections from bacteria found in everyday foods.

If neutrophil counts drop to near or below 1000, patients should be on a neutropenic diet and should be in close touch with their hematologists. Following are examples of foods that must be avoided when on a neutropenic diet:

Raw nuts, vegetables, and salads
Apples, peaches, grapes, plums, nectarines, kiwi, strawberries, and other uncooked thin-skinned fruits
Self-serve buffets, salad bars, and deli foods
Cheeses such as feta, brie, camembert, blue, etc.
Raw or rare meats, fish, and poultry
Commercially prepared potato or macaroni salad
Raw, un-pasteurized milk and eggnog or milkshakes made with raw eggs
Bakery breads, muffins, cakes donuts, and cream or custard filled cakes

In addition to the selection of appropriate foods, extra care is important in food preparation. Food preparers must wash their hands frequently in warm soapy water, especially if handling raw meat, chicken, eggs, and fish. Counter tops, cutting boards, and cooking utensils should also be washed with hot soapy water after they have come in contact with food.

Additional information on food preparation and foods that are safe for patients with neutropenia can be found on-line at http://www.acor.org/leukemia/neutro.html.