How we evaluate and treat neutropenia in adults

Gibson, Christopher J.; Berliner, Nancy

doi:10.1182/blood-2014-02-482612

Cited by 97 publications

(118 citation statements)

References 56 publications

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“…1 Severe chronic primary neutropenia (CPN) in adults includes true idiopathic neutropenia (CIN), primary autoimmune neutropenia defined by the presence of neutrophil autoantibodies, and CPN associated with a T-cell clone (excluding large granular lymphocyte leukemia). [2][3][4][5][6][7][8][9][10] So far, there is no evidence based on clinical characteristics and outcome to consider these entities as different.…”

Section: Introductionmentioning

confidence: 99%

Severe chronic primary neutropenia in adults: report on a series of 108 patients

Fontbrune

Moignet

Beaupain

et al. 2015

Blood

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International audienceSevere chronic primary neutropenia (CPN) is a rare entity, and long-term outcome and risk factors for infections in severe CPN adults have not been described to date. We report the characteristics and outcomes of 108 severe adult CPN patients enrolled in a multi-institutional observational study. Severe CPN adults were mostly female (78%), and median age at diagnosis was 28.3 years. Diagnosis was fortuitous in 62% of cases. The median absolute neutrophil count (ANC) at diagnosis was 0.4 × 109/L, and median ANC without granulocyte colony-stimulating factor (G-CSF) during follow-up was 0.5 × 109/L. Twenty-three of 66 (34.8%) evaluable patients had neutrophil autoantibodies, and 6 of 47 (12.8%) a T-cell clone. The presence of neutrophil autoantibodies or T-cell clone was not associated with any specific clinical or biological characteristics. No death or hematologic malignancies occurred, and 44 severe bacterial infections were reported in 27 patients with a median follow-up of 8.3 years. Fifty patients received G-CSF either sporadically (n = 24) or continuously (n = 26) and responded (96%). Nineteen patients received immunosuppressive therapies: overall response (OR) was 41%, and median duration of response was 3 months. At diagnosis, the only predictive factor for the occurrence of severe bacterial infections was an ANC count below 0.2 × 109/L (OR, 0.76). Severe CPN in adults is characterized by a female predominance and a benign outcome with a low rate of severe bacterial infections and no secondary malignancies. G-CSF is efficient and well tolerated but is not required in a majority of patient

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Section: Introductionmentioning

confidence: 99%

Severe chronic primary neutropenia in adults: report on a series of 108 patients

Fontbrune

Moignet

Beaupain

et al. 2015

Blood

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“…1 A separate chapter includes the congenital neutropenia, that are hereditary blood diseases usually identified during the childhood and adolescence, typically of pediatric interest.…”

Section: Differential Diagnosis Of Neutropeniamentioning

confidence: 99%

Agranulocytosis in a patient with acute Parvovirus B19 infection: a case study

et al. 2016

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The definition of neutropenia is the reduction in the absolute number of neutrophils below 1.5×10<sup>9</sup>. The chapter about acquired neutropenias affecting the adult population is of particular interest to the internist. PC, 75 years old man, was hospitalized because of fever, asthenia. In anamnesis: recent diagnosis of ulcerative pancolitis treated with mesalazine and corticosteroid therapy. During the hospitalization, to the fever resolution, we witnessed to a gradual reduction in the value of neutrophils leucocytes until the complete agranulocytosis. We set a therapy with granulocytes colony stimulating factors, and antifungal. The osteo-medullar biopsy confirmed a pure aplasia of the granulocyte marrow series without any evidence of cancer. The subsequent clinical development was favorable, with stable apyrexia and recovery of leucocytes count. Few days after, we received the positive response on the research of anti-Parvovirus B19 immunoglobulin M and in qualitative polymerase chain reaction. The patient was discharged with diagnosis <em>agranulocytosis in patient with acute infection of Parvovirus B19</em>. Neutropenia associated with Parvovirus infection is not frequent and is related to the presence of hematological diseases or condition of immunosuppression. The peculiarity of the case described is the complete agranulocytosis found: in fact in literature, only rare cases are described. Patient gave his informed consent.

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“…All other experimental groups of animals were given cyclophosphamide [16] in a triple intramuscular injection at a dose of 30 mg/kg in a saline on average 0.6 mL of 1% solution. At 6th, 7th, and 8th day of the experiment the animals of 1st-7th experimental group were injected intramuscularly with 1st, 2nd, 3rd, 4th, and 5th groups, an average of 0.1 mL of 1% solution (5 mg/kg, saline), , , , , and , respectively, 6th, 0.1 mL of saline solution (placebo), and 7th, an average of 0.1 mL (5 mg/kg) of 1% solution of methyluracil [1,2] (the drug for comparison). Blood sampling was performed at 09.00 am from the orbital vein of rats in sterile hematologic tubes VF-052SDK with 2 mL of EDTA (K2) on 12th, 19th, 33rd, and 40th days of the experiment (1,7,21, and 28 days after injection of , -) under the mild anesthesia with ether.…”

Section: Peripheral Blood Hemogram Studiesmentioning

confidence: 99%

“…), different kind of irradiation, and so on. At mild leukopenia pyrimidine derivatives like methyluracil (methacin) and pentoxylum, which convert in the body to methyluracil, are administered [1,2]. Both drugs stimulate the synthesis of nucleic acids, proteins, cell division, leukopoiesis, and tissue regeneration and are administered to patients with burns, fractures, and long-term healing wounds as well as to those who in need to increase specific and nonspecific immune resistance of the organism.…”

Section: Introductionmentioning

confidence: 99%

Synthesis and Biological Evaluation of 1,3,8-Triazaspiro[4.5]decane-2,4-dione Derivatives as Myelostimulators

Yu¹,

Ten²,

Baktybayeva

et al. 2018

Journal of Chemistry

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Spiroconnected N-alkoxyalkylpiperidine hydantoins were obtained via the Strecker reaction of cyanohydrin with ammonium carbonate. 1,3,8-Triazaspiro[4.5]decane-2,4-diones have shown the myelostimulating activity in the artificially induced (with cyclophosphamide) myelodepressive syndrome. The compounds significantly accelerated the regeneration of lymphocyte and granulocyte cell pool of bone marrow hematopoiesis.

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How we evaluate and treat neutropenia in adults

Cited by 97 publications

References 56 publications

Severe chronic primary neutropenia in adults: report on a series of 108 patients

Severe chronic primary neutropenia in adults: report on a series of 108 patients

Agranulocytosis in a patient with acute Parvovirus B19 infection: a case study

Synthesis and Biological Evaluation of 1,3,8-Triazaspiro[4.5]decane-2,4-dione Derivatives as Myelostimulators

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