From the Research
Benign ethnic neutropenia (BEN) generally requires no specific treatment as it is a normal variant rather than a pathological condition, and management primarily involves recognizing BEN to avoid unnecessary interventions, particularly in individuals of African, Middle Eastern, or Mediterranean descent who commonly have lower baseline neutrophil counts. When evaluating neutropenia in these populations, physicians should consider using adjusted reference ranges (typically accepting absolute neutrophil counts as low as 1,000-1,500/μL rather than the standard 1,500-2,000/μL cutoff) 1.
Key aspects of managing BEN include:
- Recognizing BEN to avoid unnecessary interventions
- Using adjusted reference ranges for neutrophil counts in affected populations
- Proceeding with normal dosing of medications that can cause neutropenia, but with adjusted monitoring thresholds
- Avoiding prophylactic use of granulocyte colony-stimulating factors (G-CSF) unless counts fall significantly below the patient's personal baseline or they develop signs of infection 2, 3.
The most recent and highest quality study, published in 2024, highlights the importance of genetic testing for BEN in patients receiving clozapine treatment, as it can help identify undiagnosed cases and prevent unnecessary withdrawal of clozapine 4.
Overall, the approach to managing BEN should prioritize distinguishing it from pathological neutropenia, confirming the absence of infection, normal bone marrow function, stable counts over time, and normal immune function, to prevent unnecessary diagnostic procedures, medication discontinuations, or dose reductions that could compromise treatment of the patient's primary condition 5.