{
  "id": "anc",
  "version": "73e56f525cf0",
  "status": "published",
  "name": "Absolute Neutrophil Count Calculator",
  "question": "What is my ANC?",
  "summary": "Calculates the absolute neutrophil count (ANC) from the white blood cell count and the percent of segmented neutrophils and bands, and grades neutropenia with the NCI CTCAE cut-offs.",
  "category": "health",
  "subcategory": "clinical",
  "url": "https://www.acalculator.org/health/anc-calculator",
  "markdown": "https://www.acalculator.org/health/anc-calculator.md",
  "kind": "function",
  "method": "ANC (cells/µL) = WBC (×10³/µL) × 1,000 × (% segmented neutrophils + % bands) ÷ 100.",
  "assumptions": [
    "The white cell count is in thousands per microliter (×10³/µL), which is the same number as ×10⁹/L.",
    "Bands left empty count as 0. The ANC is rounded to a whole number, and the grade is read from that number.",
    "Grades follow the NCI CTCAE v5.0 cut-offs of 1,500, 1,000, and 500 cells/µL. Some labs set their lower limit of normal a little differently."
  ],
  "inputs": {
    "$schema": "https://json-schema.org/draft/2020-12/schema",
    "type": "object",
    "properties": {
      "wbc": {
        "title": "White blood cells (×10³/µL)",
        "description": "White blood cell count, in thousands per microliter (the same number as ×10⁹/L). A count of 6,500/µL is 6.5.",
        "type": "number",
        "minimum": 0.01,
        "maximum": 500
      },
      "segs": {
        "title": "Segmented neutrophils",
        "description": "Percent of segmented (mature) neutrophils in the differential (\"segs\" or \"polys\").",
        "type": "number",
        "x-unit": "percent",
        "minimum": 0,
        "maximum": 100
      },
      "bands": {
        "title": "Band neutrophils",
        "description": "Percent of band (young) neutrophils in the differential. Enter 0 if the report has none.",
        "type": "number",
        "x-unit": "percent",
        "minimum": 0,
        "maximum": 100
      }
    }
  },
  "outputs": {
    "anc": {
      "label": "Absolute neutrophil count",
      "description": "Neutrophils per microliter of blood, rounded to a whole number.",
      "format": "integer"
    },
    "grade": {
      "label": "Neutropenia grade",
      "description": "The CTCAE v5.0 grade for the ANC.",
      "format": "text"
    },
    "ancSi": {
      "label": "ANC (×10⁹/L)",
      "description": "The same count in SI units: cells/µL ÷ 1,000.",
      "format": "number"
    }
  },
  "defaultAnswer": {
    "inputs": {
      "wbc": 6.5,
      "segs": 55,
      "bands": 3
    },
    "outputs": {
      "anc": 3770,
      "grade": "Not neutropenic (1,500 or more)",
      "ancSi": 3.77
    },
    "text": "Your absolute neutrophil count is 3,770 cells/µL: Not neutropenic (1,500 or more)."
  },
  "examples": [
    {
      "given": {
        "wbc": 6.5,
        "segs": 55,
        "bands": 3
      },
      "expect": {
        "anc": 3770,
        "grade": "Not neutropenic (1,500 or more)",
        "ancSi": 3.77
      },
      "source": "ANC = WBC × (segs + bands) ÷ 100: 6,500 × 58% = 3,770 cells/µL (hand calculation in content.mdx); National Cancer Institute, NCI Dictionary of Cancer Terms, absolute neutrophil count. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/absolute-neutrophil-count"
    },
    {
      "given": {
        "wbc": 2.1,
        "segs": 40,
        "bands": 5
      },
      "expect": {
        "anc": 945,
        "grade": "Moderate neutropenia (500 to 999)",
        "ancSi": 0.945
      },
      "source": "2,100 × 45% = 945 cells/µL, CTCAE v5.0 grade 3 range 500 to under 1,000 (hand calculation in content.mdx); National Cancer Institute, Common Terminology Criteria for Adverse Events (CTCAE) v5.0, Neutrophil count decreased (grades by cells/µL). https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm"
    },
    {
      "given": {
        "wbc": 0.8,
        "segs": 30
      },
      "expect": {
        "anc": 240,
        "grade": "Severe neutropenia (under 500)",
        "ancSi": 0.24
      },
      "source": "800 × 30% = 240 cells/µL, bands left out count as 0; CTCAE v5.0 grade 4 is under 500 (hand calculation); National Cancer Institute, Common Terminology Criteria for Adverse Events (CTCAE) v5.0, Neutrophil count decreased (grades by cells/µL). https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm"
    },
    {
      "given": {
        "wbc": 3,
        "segs": 50,
        "bands": 0
      },
      "expect": {
        "anc": 1500,
        "grade": "Not neutropenic (1,500 or more)",
        "ancSi": 1.5
      },
      "source": "3,000 × 50% = 1,500 cells/µL, exactly on the CTCAE cut-off, which is not neutropenic (hand calculation); National Cancer Institute, Common Terminology Criteria for Adverse Events (CTCAE) v5.0, Neutrophil count decreased (grades by cells/µL). https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm"
    }
  ],
  "sources": [
    "National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v5.0, \"Neutrophil count decreased\". 2017. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm",
    "Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Butterworths; 1990. https://www.ncbi.nlm.nih.gov/books/NBK201/ (white cell count and differential)",
    "Merz LE. A paradigm shift in neutrophil adverse event grading: why now? HemaSphere. 2025;9(10):e70242. https://doi.org/10.1002/hem3.70242 (CTCAE v5.0 and v6.0 neutrophil grades; retrieved 2026-09-29)",
    "National Cancer Institute. NCI Dictionary of Cancer Terms: absolute neutrophil count. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/absolute-neutrophil-count"
  ],
  "related": [],
  "changelog": [
    {
      "date": "2026-09-29",
      "note": "Published after this site's editorial review against the cited sources (no clinician review); the page notice says so."
    },
    {
      "date": "2026-09-29",
      "note": "Worked examples name a published reference for their rule."
    }
  ]
}