How to approach neutropenia.

نویسنده

  • Laurence A Boxer
چکیده

Neutropenia is defined as the reduction in the absolute number of neutrophils in the blood circulation. Acute neutropenia is a relatively frequent finding, whereas disorders of production of neutrophils are quite rare. Acute neutropenia is often well tolerated and normalizes rapidly. Neutropenia arising as a result of underlying hematologic disorders is far more significant. Such a patient may be at risk for infectious complications and will likely require a thorough investigation. Acute neutropenia evolves over a few days and occurs when neutrophil use is rapid and production is impaired. Chronic neutropenia may last for 3 months or longer and is a result of reduced production, increased destruction, or excessive splenic sequestration of neutrophils. Neutropenia may be classified by whether it arises secondarily to causes extrinsic to BM myeloid cells, which is common; as an acquired disorder of myeloid progenitor cells, which is less frequent; or as an intrinsic defect arising from impaired proliferation and maturation of myeloid progenitor cells in the BM, which is rare. Severe neutropenia with absolute neutrophil counts below 500/μL increases susceptibility to bacterial or fungal infections. Multiple disorders of severe congenital neutropenia have been found by the discovery of genetic defects affecting differentiation, adhesion, and apoptosis of neutrophil precursors. Elucidation of the multiple genetic defects have provided insight into the biology of the cell involving membrane structures, secretory vesicles, mitochondrial metabolism, ribosome biogenesis, transcriptional regulation, and cytoskeletal dynamics, as well as the risk for myelodysplasia and acute myeloid leukemia.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Management of Febrile Neutropenia in Children with Cancer; a Practical Guide to Diagnosis and Treatment

This study aimed to provide an evidence-based guideline for the clinical management of febrile neutropenia in children with cancer. In this narrative review, the most recently published sources of information on febrile neutropenia consisting of textbooks and articles, have been reviewed. We focused on the more recent data about diagnosis, treatment and management in children through the use o...

متن کامل

Correlation between Late-onset Neutropenia, Sepsis and Associated Factors in Preterm Infants: A single center study

Background: Late onset neutropenia (neutropenia after 3 weeks of life) may be a physiological condition without need to prescribe antibiotics, G-CSF, or IVIG. We aimed to determine the association between sepsis and late onset neutropenia in very low birth weight (<1500 gm) infants.&nbsp; Methods: This study was a cross-sectional prospective study in VLBW infants that were admitted in Mahdieh ...

متن کامل

How I diagnose and treat neutropenia.

PURPOSE OF REVIEW Neutropenia absolute neutrophil count (ANC) less than 1.5 × 10(9)/l is a common hematological finding, and severe neutropenia, that is, ANC less than 0.5 × 10(9)/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 ...

متن کامل

Assessment of procalcitonin as a diagnostic marker of infection in pediatrics with cancer complicated by fever and neutropenia

Background: Febrile neutropenia is still one of the most important complications of treatment in cancer patients. These patients become prone to infection and consequently higher mortality and morbidity. This study aimed to determine the accuracy of serum procalcitonin (PCT) level in the detection of infection in pediatric cancer patients complicated with febrile neutropenia. Materials and Met...

متن کامل

Main Determinants of Severe Neutropenia in Patients with Solid Tumors Receiving Adjuvant Chemotherapy

Background:Chemotherapy-induced neutropenia as a major toxicity of systemic chemotherapy is commonly associated with substantial mortality and morbidity, and thus identifying its determinants is necessary. This study was undertaken to identify main risk factors of severe neutropenia following adjuvant chemotherapy treatment in a community-based population of patients with cancer in Semnan, I...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Hematology. American Society of Hematology. Education Program

دوره 2012  شماره 

صفحات  -

تاریخ انتشار 2012