Smoking as a Cause for Mild Chronic Neutrophilia.

Abstract

Mild chronic neutrofilia is a frequent reason for hematologic consultation and in 70% of the cases there is no identifiable cause. Objective: to determine if smoking habit could be the etiology for leucocytosis with neutrophilia in smokers with no other pulmonary associated disease. Materials and Methods: We questioned 300 consecutive blood donors from our institution, elaborating a complete record of smoking habit. Immediately before blood donation an automated complete blood count was performed. Leucocytosis was defined as a white cell count above 11 x 109/L, and neutrophilia as a neutrophil count over 7.7 x 109/L. All data is stated as mean value ± 1 SD. Results: we studied 195 (65%) men and 105 (35%) women (n=300). Mean age was 36.5 y.o. (18–69). Fifty-five percent (165/300) smoke or were previous smokers; 8.4% (14/165) of these, did not smoke at the time of this investigation, and only two have quit smoking a year prior to questioning. Mean time of duration of smoking habit was 16.4 years ± 10.6 and the average amount of cigarettes smoked through life (estimated from data referred along different phases of each subject’s history) was 1.26 x 105 ± 1.21 x 105. In the following table results from smokers (previous or actual) vs. non-smokers are compared. Leucocytosis was present in 37/165 (22.4%) of smokers and in 3/135 (2.2%) of non-smokers (p<0.001) and neutrophilia was noted in 19/165 (11.5%) of smokers and in 2/135 (1.5%) of non-smokers (p<0.001). None of the volunteers had a WBC count over 20 x 109/L. A direct association was established for the number of cigarettes smoked and the WBC count and neutrophil count. Discussion: smoking habit affects ciliar movement, inhibits alveolar macrophage function and produces hyperplasia on mucous glands within bronquial walls. These alterations result in entrapment of mucous secretions that will ultimately lead to bacterial colonization. The neutrophilia observed in smokers would be the result of a normal physiologic response to a potential infectious focus. In conclusion, is our understanding that the smoking habit should be considered as a common etiology for mild leucocytosis and neutrophilia. Smokers (n:165) Non-smokers (n:135) p (t-test) WBC x 109/L 9.6 ± 2.1 6.8 ± 1.3 < 0.001 Neutrophils x 109/L 5.7 ± 1.6 3.9 ± 1.0 < 0.001 Hct % 45.9 ± 3.7 45.2 ± 3.6 NS Platelets 207 ± 48.7 206.4 ± 45.8 NS

Tobacco smoking causes secondary polycythemia and a mild leukocytosis among heavy smokers in Taif City in Saudi Arabia

“…Moreover, the whole blood analysis of both participated groups revealed an elevation in white blood cell counts and differential in smokers and that elevation was statistically significant in neutrophil counts as shown in Table 2. These findings are highly consistent with several published studies (Higuchi et al, 2016, Schwartz and Weiss, 1991, Schwartz and Weiss, 1994, Stemmelin et al, 2004). In fact, several reports emphasized that tobacco smoking causes vascular injury which in turn elevates inflammatory markers and leukocyte counts and that may interpret the neutrophil count increase in smokers as found in this study (Lee et al, 2012, Smoking and inflammation, 2005, Tibuakuu et al, 2017).…”

Smoking is associated with pneumonia development in lung cancer patients

“…Nicotine can suppress natural killer (NK) cell activity. NK cells are usually activated immune response against viral infections [29][30][31]. Agostini et al [16] have noted that smoking increases postoperative pulmonary complications such as increased hospital mortality, intensive care unit admission rate, and hospital length of stay.…”

Smoking is associated with pneumonia development in lung cancer patients

“…Nicotine can suppress natural killer (NK) cell activity. NK cells are usually activated immune response against viral infections [29][30][31]. Agostini et al [17] have noted that smoking increases postoperative pulmonary complications such as increased hospital mortality, intensive care unit admission rate, and hospital length of stay.…”