From the Research
Introduction to Neutropenia
Neutropenia is a condition characterized by a reduction in the absolute number of neutrophils in the blood circulation [(1,2)]. This condition can be classified as acute or chronic, with chronic neutropenia lasting for 3 months or longer 2.
Effects of Neutropenia
The effects of neutropenia can be severe, with patients at risk of developing life-threatening bacterial or fungal infections [(1,2,3)]. The risk of infection is greatest with severe neutropenia, and patients may present with symptoms such as oral ulcers, inflammation, and recurrent skin infections 3.
Increased Risk of Infection
Patients with neutropenia are at an increased risk of infection, particularly with severe neutropenia [(2,3,4)]. This risk is directly proportional to the severity and duration of neutropenia 4.
Classification of Neutropenia
Neutropenia can be classified according to the etiology as congenital or acquired 4. Acquired neutropenia can be further classified as extrinsic or intrinsic, with extrinsic causes including impaired proliferation and maturation of myeloid progenitor cells in the bone marrow 1.
Treatment and Management
Treatment of neutropenia is aimed at managing the underlying cause of the condition 1. Patients with febrile neutropenia should undergo treatment with antibiotics 1. Other treatments include administration of granulocyte colony-stimulating factor (G-CSF) to increase neutrophil production 5. Patients with severe chronic neutropenia require monitoring for the development of myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) 5.
Dosing and Duration of Treatment
The dosing and duration of treatment with G-CSF vary depending on the individual patient and the underlying cause of neutropenia 5. Patients with cyclic, idiopathic, and autoimmune neutropenia have virtually no risk of evolving to MDS or AML 5.
Caveats and Differentials
It is essential to consider the clinical status of the patient and the duration of leukopenia when assessing patients with neutropenia 1. A careful review of the patient's medical history, family history, and physical examination is crucial in evaluating patients with neutropenia 3. Hematopoietic stem cell transplantation is a curative therapy for congenital neutropenia with MDS/AML or with cytogenetic abnormalities indicating impending conversion 5.