Clinical Outcomes of Patients Referred for Asymptomatic Neutropenia at a Single Academic Center: A Focus on Racial Disparities

Development of Duffy Null–Specific Absolute Neutrophil Count Reference Ranges

“…The incidence of type 1 diabetes in children increased during the COVID-19 pandemic, [1][2][3][4] but studies have not discriminated between children with and without infection. We analyzed a large populationbased, individual-patient data set that included diagnoses of COVID-19 to determine whether there was a temporal association between COVID-19 and type 1 diabetes in children.…”

“…With 70% of medical decisions based on laboratory values, reference ranges that do not reflect normal values for a significant proportion of the population may lead to iatrogenic harm. For example, increased testing and referrals and discontinuation of critical medications like azathioprine have been found among individuals with Duffy null status and ANCs below conventional reference ranges . We aimed to establish a Duffy null phenotype–specific ANC reference range at our multi-institutional academic center.…”

Psychological toxicity in classical hematology

“…In truth, as many as 20% of CBCs yield at least one “abnormal” value 1 . Since normal ranges generally represent ± two standard deviations, by definition 5% of individuals inherently fall outside of “normal.” Additionally, these supplied normal values do not accurately reflect the distribution of blood counts for all peoples equally 2 . These incidental findings can lead to a cascade of other testing, including bone marrow biopsy and expensive genetic evaluations, which can impart significant financial and psychological toxicity if not properly managed (Figure 1).…”

“…Additionally, these supplied normal values do not accurately reflect the distribution of blood counts for all peoples equally. 2 These incidental findings can lead to a cascade of other testing, including bone marrow biopsy and expensive genetic evaluations, which can impart significant financial and psychological toxicity if not properly managed (Figure 1). The purpose of this review is to highlight the psychologic duress that can be imparted to a patient upon referral to a hematologistoncologist for laboratory findings that do not impact their long-term survival.…”