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How I diagnose and treat neutropenia

Dale, David C.

Current Opinion in Hematology: January 2016 - Volume 23 - Issue 1 - p 1–4
doi: 10.1097/MOH.0000000000000208
MYELOID BIOLOGY: Edited by David C. Dale
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Purpose of review Neutropenia absolute neutrophil count (ANC) less than 1.5 × 109/l is a common hematological finding, and severe neutropenia, that is, ANC less than 0.5 × 109/l is a well known risk factor for susceptibility to bacterial infections. This review provides a succinct clinical approach to the diagnosis and treatment of neutropenia with specific recommendations on the treatment of severe chronic neutropenia with the myeloid growth factor, granulocyte colony-stimulating factor (G-CSF).

Recent findings Experts agree that patients with acute febrile neutropenia should be treated with antibiotics and that patients at high risk of severe neutropenia (>20% risk) after myelosuppressive chemotherapy should be treated prophylactically with a myeloid growth factor, usually G-CSF. The diversity of causes and consequences of chronic neutropenia make the diagnosis and management of these patients more complicated.

Summary The review provides a stepwise approach to neutropenia focusing first on reaching a provisional diagnosis and treatment plan then steps to a final diagnosis. It also provides specific recommendations on the treatment of severe chronic neutropenia with G-CSF.

Department of Medicine, University of Washington, Seattle, Washington, USA

Correspondence to David C. Dale, MD, Department of Medicine, University of Washington, Box 356422, 1959 NE Pacific St., Seattle, WA 98195, USA. Tel: +1 206 543 7215; e-mail: dcdale@u.washington.edu

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