Labs & Drug Levels

Absolute Neutrophil Count (ANC) Calculator

Neutrophils per microliter from the white count and the segmented and band percentages, with neutropenia grades.

Reviewed by Alex G, BSN, RN, CEN, CCRN, CMC, NREMT-P · From the Reference tab of the app

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Formula

ANC (cells/µL) = WBC (×10³/µL) × 1000 × (% segmented neutrophils + % bands) ÷ 100
CTCAE v6.0: grade 1 under 1500 to 1000, grade 2 under 1000 to 500, grade 3 under 500 to 100, grade 4 under 100

Reference: Normal 1500 or more

How it is used

• Febrile neutropenia: ANC under 500, or expected to fall below 500 within 48 hours, with a single oral temperature of 38.3 °C or 38.0 °C sustained over 1 hour; profound neutropenia is under 100 (IDSA 2011).
• CTCAE v6.0 (2025, in NCI trials from 2026) grades a given count one level lower than v5.0, where grade 4 was under 500 and grade 1 began at the lower limit of normal (Merz 2025).
• People with the Duffy-null phenotype, common with African ancestry, have a normal lower limit of about 1200–1540 rather than about 2000, with no extra infection risk (Merz 2025).

Key points

• Fever with an ANC under 500, or expected to fall below 500, is an emergency: blood cultures and empiric broad-spectrum antibiotics without waiting for results (IDSA 2011).

Same formula as the app. Open it in the web app.

Related one-pagers

• Oncologic EmergenciesFever ≥38.3 °C once or ≥38.0 °C for 1 h, with ANC <500 or expected <500 in 48 h (IDSA 2010)
• End of Life, Brain Death and Organ DonationAncillary · If exam or apnea test incomplete: angiography, radionuclide flow, TCD
• Neuro: ICP and StrokeAncillary tests only if the exam or apnea test cannot be completed: catheter angiography, radionuclide perfusion or TCD; EEG and CTA do not count
• Mental Health: Meds and CommunicationClozapine ANC: ≥1,500/µL to start (≥1,000 if benign ethnic neutropenia); weekly to 6 months, every 2 weeks to 12, then monthly. REMS ended 2025.

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For education and exam preparation only. Follow your institution’s protocols. For education and exam preparation only. Verify results independently and follow your institution’s protocols. Not a substitute for clinical judgment.