# What is my ANC?

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.

- Page: https://www.acalculator.org/health/anc-calculator
- JSON spec: https://www.acalculator.org/health/anc-calculator.json
- Version: 73e56f525cf0

## Default answer

Example with the default inputs (White blood cells (×10³/µL) 6.5, Segmented neutrophils 55%, Band neutrophils 3%): Your absolute neutrophil count is 3,770 cells/µL: Not neutropenic (1,500 or more).

## Inputs

| Key | Label | Description |
| --- | --- | --- |
| wbc | White blood cells (×10³/µL) | White blood cell count, in thousands per microliter (the same number as ×10⁹/L). A count of 6,500/µL is 6.5. |
| segs | Segmented neutrophils | Percent of segmented (mature) neutrophils in the differential ("segs" or "polys"). |
| bands | Band neutrophils | Percent of band (young) neutrophils in the differential. Enter 0 if the report has none. |

## Outputs

| Key | Label | Description |
| --- | --- | --- |
| anc | Absolute neutrophil count | Neutrophils per microliter of blood, rounded to a whole number. |
| grade | Neutropenia grade | The CTCAE v5.0 grade for the ANC. |
| ancSi | ANC (×10⁹/L) | The same count in SI units: cells/µL ÷ 1,000. |

## 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.

## Worked examples

1. wbc = 6.5, segs = 55%, bands = 3% gives anc = 3,770, grade = Not neutropenic (1,500 or more), ancSi = 3.77. Source: National Cancer Institute, NCI Dictionary of Cancer Terms, absolute neutrophil count. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/absolute-neutrophil-count.
2. wbc = 2.1, segs = 40%, bands = 5% gives anc = 945, grade = Moderate neutropenia (500 to 999), ancSi = 0.945. Source: 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.
3. wbc = 0.8, segs = 30% gives anc = 240, grade = Severe neutropenia (under 500), ancSi = 0.24. Source: 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.
4. wbc = 3, segs = 50%, bands = 0% gives anc = 1,500, grade = Not neutropenic (1,500 or more), ancSi = 1.5. Source: 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.

## FAQ

### What is the ANC?

The absolute neutrophil count (ANC) is the number of neutrophils, a type of white blood cell that fights bacterial and fungal infection, in one microliter of blood. A low ANC (neutropenia) raises the risk of infection. It is watched closely during chemotherapy.

### How do you calculate the ANC?

Multiply the white blood cell count by the percent of neutrophils, counting both mature (segmented) neutrophils and bands. For a white count of 6,500/µL with 55% segs and 3% bands: 6,500 × 0.58 = 3,770 cells/µL.

### What ANC is too low?

The NCI Common Terminology Criteria for Adverse Events (CTCAE v5.0) grade a count of 1,000 to 1,499 cells/µL as grade 2, 500 to 999 as grade 3, and under 500 as grade 4. Grade 1 is a count below the lab's lower limit of normal but still 1,500 or more. Many clinicians call these ranges mild, moderate, and severe neutropenia. A fever with an ANC under 500 is a medical emergency.

### Why are bands included?

Bands are young neutrophils that already fight infection, so they count toward the ANC. If the report does not list bands, leave that field at 0.

### Are the units ×10³/µL and ×10⁹/L the same?

Yes. 10³ cells per microliter is the same as 10⁹ cells per liter, so a white count of 6.5 ×10³/µL is 6.5 ×10⁹/L. The page shows the ANC in cells/µL and in ×10⁹/L.

## 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