Frequency of benign neutropenia among Black versus White individuals undergoing a bone marrow assessment

Abstract

Healthy individuals in the United States identified as having Black race have lower neutrophil counts, on average, than individuals identified as having White race, which could result in more negative diagnostic evaluations for neutropenia. To test this hypothesis, the proportion of evaluations where the final diagnosis was clinically insignificant neutropenia for Black and White individuals who underwent an evaluation by a haematologist that included a bone marrow (BM) biopsy to investigate neutropenia was assessed. 172 individuals without prior haematological diagnoses who underwent a haematological evaluation to investigate neutropenia. Individuals diagnosed with clinically insignificant neutropenia between Black and White individuals were compared using a propensity‐score‐adjusted logistic regression. Of 172 individuals, 42 (24%) were classified as Black race, 86 (50%) were males, and the 79 (46%) were over 18 years old. A BM biopsy did not identify pathology in 95% (40 of 42) of Black individuals and 68% (89 of 130) of White Individuals. Black individuals (25 of 42 [60%]) received a final diagnosis of clinically insignificant neutropenia, compared to White individuals (12 of 130 [9%]) (adjusted odds ratio =7.9, 95% CI: 3.1 – 21.1). We conclude that black individuals were more likely to receive a diagnosis of clinically insignificant neutropenia after haematological assessment.

Uric Acid to High-Density Lipoprotein Cholesterol Ratio is a Novel Marker to Predict Functionally Significant Coronary Artery Stenosis

“…Nevertheless, studies on predicting FFR in the Chinese population are rare. Considering factors (such as white blood cells [10] and highdensity lipoprotein [11]) affected by race, region, and diet, additional clinical studies from different countries are essential.…”

Ancestry,ACKR1and leucopenia in patients with systemic lupus erythematosus

“…Although the CC genotype is not associated with increased risk of infection or other illnesses, lower white cell counts and more frequent occurrences of leucopenia can have medical consequences that result from altered care triggered by the finding of a low white cell count. 25 For example, individuals with the CC genotype were more likely to undergo a bone marrow biopsy for isolated leucopenia than those with CT/TT genotypes, and 97% of their biopsies had normal results. 26 …”

“…22 Although the CC genotype is not associated with increased risk of infection or other illnesses, lower white cell counts and more frequent occurrences of leucopenia can have medical consequences that result from altered care triggered by the finding of a low white cell count. 25 For example, individuals with the CC genotype were more likely to undergo a bone marrow biopsy for isolated leucopenia than those with CT/TT genotypes, and 97% of their biopsies had normal results. 26 In patients with SLE, leucocyte counts are usually obtained before initiation of cytotoxic drugs, and low white cell counts could preclude patients from receiving such drugs, or such patients might receive lower doses of cytotoxic drugs or be more likely to discontinue therapy because the low white cell counts are attributed to drug toxicity.…”

Clinical associations with a polygenic predisposition to benign lower white blood cell counts

“…Carriers of this genotype are more likely to undergo diagnostic investigations, including a bone marrow biopsy, and to have medications stopped due to concerns for toxicity 7 – 10 . These actions are driven, in part, by the use of WBC count reference ranges that are not calibrated to this genotype 11 , 12 . While the rs2814778-CC genotype is not prevalent among European ancestry (EA) populations, numerous common single nucleotide polymorphisms (SNPs) associated with WBC count variation have been identified in this group 13 , 14 .…”