Clinical Significance of Neutropenia in Routine Complete Blood Cell Counts

A new study found the prevalence of neutropenia in routine complete blood cell counts directly associated with viral infections, hematological malignancies, and mortality. While it is common knowledge that neutropenia may accompany a variety of diseases, the clinical implications of neutropenia detected in a routine complete blood cell count is often neglected.

Neutropenia is defined as an absolute blood neutrophil count, commonly known as ANC, and it means the real number of white blood cells that are neutrophils. Neutrophils are key components in the system of defense against infection. An absence or scarcity of neutrophils—a condition called neutropenia—makes a person vulnerable to infections.

Although mild and moderate neutropenia are rarely associated with severe infectious complications, they can be of clinical importance as they may be markers of an underlying condition such as autoimmune, viral and hematological disorders or solid cancers.

The purpose of the research is to analyze the risks of an autoimmune, hematological or viral disorder, as well as all-cause mortality, in a patient with neutropenia. Understanding the risks would help general practitioners and clinics to focus on diagnostic work-up and decision-making process. The study is published in the Journal of Internal Medicine.

Neutropenia Associations

The study included 373,820 individuals from the Copenhagen Primary Care Differential Count database. The researchers evaluated the association with a number of previously recognized conditions and all-cause mortality in the 4 years following the identification of neutropenia. And then, risk estimates were measured by matching laboratory data with Danish nationwide health registers.

Neutropenia was observed in approximately 1% of all individuals. There were no increased risks of autoimmune disease, nutritional, endocrine, and other neutropenia-related conditions or overall solid cancers. But it was associated dependently with viral infections, hematological malignancies, and mortality.

Neutropenia was particularly associated with HIV, acute leukemia, and myelodysplastic syndrome. Furthermore, a direct relationship was established between severe neutropenia and increased risks of hematological malignancies and mortality from any cause.

Neutropenia Requires Careful Follow-up

The study provides in-depth insight into the prevalence and clinical significance of low ANCs. In simple words, the study highlighted that lower the ANC, the greater the likelihood of these diseases.

Neutropenia is a warning sign that requires careful follow-up. Although the number of neutropenia patients may be small, our study shows that they are at risk of viral diseases, hematological malignancies, and mortality. Therefore, when neutropenia, or even a subnormal ANC is observed, initial diagnostic work-up towards the risk of viral and hematological disorders should be immediately focused upon.

The study findings might aid in the complex multistep process that includes the overall clinical presentation.