Absolute Neutrophil Count Normal Range
The absolute neutrophil count (ANC) is the number of neutrophils in a sample of blood. Neutrophils are white blood cells, made mainly in the bone marrow, that fight infection. In most healthy adults the ANC is somewhere between about 1,500 and 7,500 cells per microlitre of blood. Below 1,500 is called neutropenia, and above about 7,500 is called neutrophilia.
Exact cut-offs vary a little between laboratories and sources, so always compare your result with the reference range printed on your own report.
Normal ANC range
| ANC (cells per microlitre) | What it usually means |
|---|---|
| Above about 7,500 | High (neutrophilia) |
| About 1,500 to 7,500 | Normal range for most adults |
| 1,000 to 1,500 | Mild neutropenia |
| 500 to 1,000 | Moderate neutropenia |
| Below 500 | Severe neutropenia |
A few points to keep in mind:
- Labs differ. Many use 1,500 as the lower limit of normal, but some use 1,800. The American Cancer Society describes a typical healthy ANC as roughly 2,500 to 6,000.
- Units differ. Some reports give the same number as cells per microlitre (cells/µL or cells/mm³), others as × 10⁹ per litre. An ANC of 1,500 cells/µL is the same as 1.5 × 10⁹/L.
How the ANC is worked out
The ANC comes from a full blood count (complete blood count, CBC). It is worked out from the total white blood cell count and the percentage of white cells that are neutrophils:
ANC = total white cell count × percentage of neutrophils
For example, a white cell count of 8,000 with 50% neutrophils gives an ANC of 4,000. Some labs report mature neutrophils (segs) and young neutrophils (bands) separately. There's more detail on the ANC formula and on segs and bands normal values.
What a low ANC means
The lower the ANC, the higher the risk of infection. Neutropenia itself usually causes no symptoms, and a mild drop is often found by chance on a routine blood test. Symptoms come from infections.
- Mild (1,000 to 1,500): often found by chance and may need no treatment.
- Moderate (500 to 1,000): infection risk is raised.
- Severe (below 500): infection risk is much higher, and bacteria that a healthy body normally keeps in check can cause illness. Untreated severe neutropenia can be life-threatening.
Common causes include chemotherapy and radiotherapy, some other medicines, viral and other infections, bone marrow and blood disorders such as leukaemia, autoimmune conditions such as lupus and rheumatoid arthritis, and low levels of vitamin B12, folate or copper. Read more on low absolute neutrophil count.
A low count that is normal for you
Some people have a lifelong ANC below 1,500 without any extra risk of infection. This inherited pattern, called benign ethnic neutropenia, is most common in people of African, Middle Eastern and West Indian descent. It is one reason a single low result needs to be interpreted by a doctor rather than read off a chart.
What a high ANC means
Neutrophilia is a sign of something else going on rather than a disease in itself. Common reasons include the body reacting to:
- infection
- inflammation, for example from rheumatoid arthritis or inflammatory bowel disease
- injury, such as a broken bone
- physical or emotional stress, or very vigorous exercise
- smoking
- some medicines
Sometimes a high count is caused by a blood disorder or blood cancer, such as chronic myeloid leukaemia or polycythaemia vera. A doctor will look at the rest of the blood count, your symptoms and any repeat tests to work out the cause.
Why the ANC matters during cancer treatment
Chemotherapy and radiotherapy can lower the neutrophil count. Because the risk of infection is much higher when the ANC falls below 500, the care team monitors it closely during treatment. They may give a medicine called granulocyte colony-stimulating factor (G-CSF), often alongside chemotherapy, to help the bone marrow make more white blood cells. Decisions about changing treatment because of a low count are for the care team.
When to get medical help urgently
If you have, or might have, a low neutrophil count (for example during chemotherapy) and you develop a temperature of 38°C (100.4°F) or higher, chills or sweating, difficulty breathing, confusion, or a stiff neck, contact your care team or doctor immediately. Fever with neutropenia is usually treated with antibiotics given into a vein, often with admission to hospital.
For any other abnormal ANC result, talk to the doctor who ordered the test. They can tell you whether it needs repeating or investigating further.
References
- Neutropenia: What It Is, Types, Symptoms & Causes. Cleveland Clinic. Accessed 8 November 2026.
- Neutrophilia: Diagnosis, Causes, Symptoms & What It Is. Cleveland Clinic. Accessed 8 November 2026.
- Understanding Your Lab Test Results. American Cancer Society. Accessed 8 November 2026.