From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The initial workup for a patient presenting with leukopenia should begin with a complete blood count with differential to confirm the leukopenia and identify which white blood cell lines are affected, as recommended by the most recent study 1. This approach is crucial because leukopenia can result from various causes, including decreased production, increased destruction, or sequestration of white blood cells. A thorough history and physical examination should follow, focusing on potential causes such as medications, recent infections, autoimmune disorders, nutritional deficiencies, and bone marrow disorders.
Key Components of the Initial Workup
- Complete blood count with differential
- Thorough history and physical examination
- Additional laboratory tests based on clinical suspicion, such as:
- Comprehensive metabolic panel
- Inflammatory markers (ESR, CRP)
- HIV testing
- Hepatitis panel
- ANA for autoimmune conditions
- Vitamin B12 and folate levels
Further Evaluation and Management
If the cause remains unclear or if bone marrow pathology is suspected, bone marrow aspiration and biopsy may be necessary, as suggested by 2. Chest X-ray and abdominal imaging might be indicated if systemic diseases are suspected. Management depends on the underlying cause and severity of leukopenia, with immediate attention to neutropenic patients (ANC <500 cells/μL) who require infection precautions and possibly empiric antibiotics, as emphasized by 1.
Considerations for Neutropenic Patients
- Infection precautions
- Possible empiric antibiotics
- Close monitoring of the patient's clinical status and white blood cell count
- Consideration of growth factor support, such as filgrastim, in certain cases, as discussed in 3
By prioritizing the most recent and highest quality study 1, we can ensure that the initial workup for leukopenia is comprehensive and tailored to the patient's clinical presentation, ultimately improving outcomes in terms of morbidity, mortality, and quality of life.