Outcomes of Isolated Neutropenia Referred to Pediatric Hematology-Oncology Clinic
BACKGROUND: Children with isolated neutropenia (absolute neutrophil count [ANC]
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| Veröffentlicht in: | Pediatrics (Evanston) 2020-10, Vol.146 (4) |
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| container_title | Pediatrics (Evanston) |
| container_volume | 146 |
| creator | Nagalapuram, Vishnu McCall, David Palabindela, Prasannalaxmi Howard, Thomas H. Bemrich-Stolz, Christina Lebensburger, Jeffrey Hilliard, Lee Wilson, Hope P. |
| description | BACKGROUND: Children with isolated neutropenia (absolute neutrophil count [ANC] |
| doi_str_mv | 10.1542/peds.2019-3637 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2440468033</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2440468033</sourcerecordid><originalsourceid>FETCH-LOGICAL-c270t-85896a9242990310abe587438e56812f101b140b3ed229927855c6451e3d040f3</originalsourceid><addsrcrecordid>eNpdkE1Lw0AURQdRsFa3rgNu3KS--UomSynaFopV0fUwnbxISpKJM5NF_72JdeXqPi6Hx-UQckthQaVgDz2WYcGAFinPeH5GZhQKlQqWy3MyA-A0FQDyklyFcAAAIXM2I2-7IVrXYkhclWyCa0zEMnnBIXrXY1eb5B0r9H4so0tesaxN9LVN1tia6Br3dUx3nf09kmVTd7W9JheVaQLe_OWcfD4_fSzX6Xa32iwft6llOcRUSVVkpmCCFcW4DcwepcoFVygzRVlFge6pgD3Hko0Iy5WUNhOSIi9BQMXn5P70t_fue8AQdVsHi01jOnRD0EwIEJkCzkf07h96cIPvxnUjJamUrMjoSC1OlPUuBI-V7n3dGn_UFPRkWE-G9WRYT4b5D_I0bMg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2451552961</pqid></control><display><type>article</type><title>Outcomes of Isolated Neutropenia Referred to Pediatric Hematology-Oncology Clinic</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Nagalapuram, Vishnu ; McCall, David ; Palabindela, Prasannalaxmi ; Howard, Thomas H. ; Bemrich-Stolz, Christina ; Lebensburger, Jeffrey ; Hilliard, Lee ; Wilson, Hope P.</creator><creatorcontrib>Nagalapuram, Vishnu ; McCall, David ; Palabindela, Prasannalaxmi ; Howard, Thomas H. ; Bemrich-Stolz, Christina ; Lebensburger, Jeffrey ; Hilliard, Lee ; Wilson, Hope P.</creatorcontrib><description>BACKGROUND: Children with isolated neutropenia (absolute neutrophil count [ANC] <1500/μL) are frequently referred to pediatric hematology and oncology clinics for further diagnostic evaluation. Scant literature exists on interventions and outcomes for isolated neutropenia. We hypothesized that children will have resolution of their neutropenia without the need for intervention(s) by a pediatric hematologist and oncologist. METHODS: We performed a 5.5-year institutional review board–approved retrospective chart review of children referred to our pediatric hematology and oncology clinics for isolated neutropenia. Neutropenia was categorized as mild (ANC of 1001–1500/μL), moderate (ANC of 500–1000 μL), severe (ANC of 201–500/μL), or very severe (ANC of ≤200/μL). RESULTS: Among 155 children referred with isolated neutropenia, 45 (29%) had mild neutropenia, 65 (42%) had moderate neutropenia, 30 (19%) had severe neutropenia, and 15 (10%) had very severe neutropenia. Only 29 (19%) children changed to an ANC category lower than their initial referral category. At a median follow-up of 12 months, 101 children had resolution of neutropenia, 40 children had mild neutropenia, 10 children had moderate neutropenia, 3 children had severe neutropenia, and 1 patient had very severe neutropenia. A specific diagnosis was not identified in most (54%) children. The most common etiologies were viral suppression (16%), autoimmune neutropenia (14%), and drug-induced neutropenia (8%). Black children had a 3.5 higher odds of having persistent mild neutropenia. Six (4%) children received granulocyte colony-stimulating factor therapy. CONCLUSIONS: Most children referred for isolated neutropenia do not progress in severity and do not require subspecialty interventions or hospitalizations.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2019-3637</identifier><language>eng</language><publisher>Evanston: American Academy of Pediatrics</publisher><subject>Children ; Colony-stimulating factor ; Granulocyte colony-stimulating factor ; Hematology ; Leukocytes (granulocytic) ; Neutropenia ; Oncology ; Pediatrics</subject><ispartof>Pediatrics (Evanston), 2020-10, Vol.146 (4)</ispartof><rights>Copyright American Academy of Pediatrics Oct 1, 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c270t-85896a9242990310abe587438e56812f101b140b3ed229927855c6451e3d040f3</citedby><cites>FETCH-LOGICAL-c270t-85896a9242990310abe587438e56812f101b140b3ed229927855c6451e3d040f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids></links><search><creatorcontrib>Nagalapuram, Vishnu</creatorcontrib><creatorcontrib>McCall, David</creatorcontrib><creatorcontrib>Palabindela, Prasannalaxmi</creatorcontrib><creatorcontrib>Howard, Thomas H.</creatorcontrib><creatorcontrib>Bemrich-Stolz, Christina</creatorcontrib><creatorcontrib>Lebensburger, Jeffrey</creatorcontrib><creatorcontrib>Hilliard, Lee</creatorcontrib><creatorcontrib>Wilson, Hope P.</creatorcontrib><title>Outcomes of Isolated Neutropenia Referred to Pediatric Hematology-Oncology Clinic</title><title>Pediatrics (Evanston)</title><description>BACKGROUND: Children with isolated neutropenia (absolute neutrophil count [ANC] <1500/μL) are frequently referred to pediatric hematology and oncology clinics for further diagnostic evaluation. Scant literature exists on interventions and outcomes for isolated neutropenia. We hypothesized that children will have resolution of their neutropenia without the need for intervention(s) by a pediatric hematologist and oncologist. METHODS: We performed a 5.5-year institutional review board–approved retrospective chart review of children referred to our pediatric hematology and oncology clinics for isolated neutropenia. Neutropenia was categorized as mild (ANC of 1001–1500/μL), moderate (ANC of 500–1000 μL), severe (ANC of 201–500/μL), or very severe (ANC of ≤200/μL). RESULTS: Among 155 children referred with isolated neutropenia, 45 (29%) had mild neutropenia, 65 (42%) had moderate neutropenia, 30 (19%) had severe neutropenia, and 15 (10%) had very severe neutropenia. Only 29 (19%) children changed to an ANC category lower than their initial referral category. At a median follow-up of 12 months, 101 children had resolution of neutropenia, 40 children had mild neutropenia, 10 children had moderate neutropenia, 3 children had severe neutropenia, and 1 patient had very severe neutropenia. A specific diagnosis was not identified in most (54%) children. The most common etiologies were viral suppression (16%), autoimmune neutropenia (14%), and drug-induced neutropenia (8%). Black children had a 3.5 higher odds of having persistent mild neutropenia. Six (4%) children received granulocyte colony-stimulating factor therapy. CONCLUSIONS: Most children referred for isolated neutropenia do not progress in severity and do not require subspecialty interventions or hospitalizations.</description><subject>Children</subject><subject>Colony-stimulating factor</subject><subject>Granulocyte colony-stimulating factor</subject><subject>Hematology</subject><subject>Leukocytes (granulocytic)</subject><subject>Neutropenia</subject><subject>Oncology</subject><subject>Pediatrics</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNpdkE1Lw0AURQdRsFa3rgNu3KS--UomSynaFopV0fUwnbxISpKJM5NF_72JdeXqPi6Hx-UQckthQaVgDz2WYcGAFinPeH5GZhQKlQqWy3MyA-A0FQDyklyFcAAAIXM2I2-7IVrXYkhclWyCa0zEMnnBIXrXY1eb5B0r9H4so0tesaxN9LVN1tia6Br3dUx3nf09kmVTd7W9JheVaQLe_OWcfD4_fSzX6Xa32iwft6llOcRUSVVkpmCCFcW4DcwepcoFVygzRVlFge6pgD3Hko0Iy5WUNhOSIi9BQMXn5P70t_fue8AQdVsHi01jOnRD0EwIEJkCzkf07h96cIPvxnUjJamUrMjoSC1OlPUuBI-V7n3dGn_UFPRkWE-G9WRYT4b5D_I0bMg</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Nagalapuram, Vishnu</creator><creator>McCall, David</creator><creator>Palabindela, Prasannalaxmi</creator><creator>Howard, Thomas H.</creator><creator>Bemrich-Stolz, Christina</creator><creator>Lebensburger, Jeffrey</creator><creator>Hilliard, Lee</creator><creator>Wilson, Hope P.</creator><general>American Academy of Pediatrics</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20201001</creationdate><title>Outcomes of Isolated Neutropenia Referred to Pediatric Hematology-Oncology Clinic</title><author>Nagalapuram, Vishnu ; McCall, David ; Palabindela, Prasannalaxmi ; Howard, Thomas H. ; Bemrich-Stolz, Christina ; Lebensburger, Jeffrey ; Hilliard, Lee ; Wilson, Hope P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c270t-85896a9242990310abe587438e56812f101b140b3ed229927855c6451e3d040f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Children</topic><topic>Colony-stimulating factor</topic><topic>Granulocyte colony-stimulating factor</topic><topic>Hematology</topic><topic>Leukocytes (granulocytic)</topic><topic>Neutropenia</topic><topic>Oncology</topic><topic>Pediatrics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nagalapuram, Vishnu</creatorcontrib><creatorcontrib>McCall, David</creatorcontrib><creatorcontrib>Palabindela, Prasannalaxmi</creatorcontrib><creatorcontrib>Howard, Thomas H.</creatorcontrib><creatorcontrib>Bemrich-Stolz, Christina</creatorcontrib><creatorcontrib>Lebensburger, Jeffrey</creatorcontrib><creatorcontrib>Hilliard, Lee</creatorcontrib><creatorcontrib>Wilson, Hope P.</creatorcontrib><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nagalapuram, Vishnu</au><au>McCall, David</au><au>Palabindela, Prasannalaxmi</au><au>Howard, Thomas H.</au><au>Bemrich-Stolz, Christina</au><au>Lebensburger, Jeffrey</au><au>Hilliard, Lee</au><au>Wilson, Hope P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Isolated Neutropenia Referred to Pediatric Hematology-Oncology Clinic</atitle><jtitle>Pediatrics (Evanston)</jtitle><date>2020-10-01</date><risdate>2020</risdate><volume>146</volume><issue>4</issue><issn>0031-4005</issn><eissn>1098-4275</eissn><abstract>BACKGROUND: Children with isolated neutropenia (absolute neutrophil count [ANC] <1500/μL) are frequently referred to pediatric hematology and oncology clinics for further diagnostic evaluation. Scant literature exists on interventions and outcomes for isolated neutropenia. We hypothesized that children will have resolution of their neutropenia without the need for intervention(s) by a pediatric hematologist and oncologist. METHODS: We performed a 5.5-year institutional review board–approved retrospective chart review of children referred to our pediatric hematology and oncology clinics for isolated neutropenia. Neutropenia was categorized as mild (ANC of 1001–1500/μL), moderate (ANC of 500–1000 μL), severe (ANC of 201–500/μL), or very severe (ANC of ≤200/μL). RESULTS: Among 155 children referred with isolated neutropenia, 45 (29%) had mild neutropenia, 65 (42%) had moderate neutropenia, 30 (19%) had severe neutropenia, and 15 (10%) had very severe neutropenia. Only 29 (19%) children changed to an ANC category lower than their initial referral category. At a median follow-up of 12 months, 101 children had resolution of neutropenia, 40 children had mild neutropenia, 10 children had moderate neutropenia, 3 children had severe neutropenia, and 1 patient had very severe neutropenia. A specific diagnosis was not identified in most (54%) children. The most common etiologies were viral suppression (16%), autoimmune neutropenia (14%), and drug-induced neutropenia (8%). Black children had a 3.5 higher odds of having persistent mild neutropenia. Six (4%) children received granulocyte colony-stimulating factor therapy. CONCLUSIONS: Most children referred for isolated neutropenia do not progress in severity and do not require subspecialty interventions or hospitalizations.</abstract><cop>Evanston</cop><pub>American Academy of Pediatrics</pub><doi>10.1542/peds.2019-3637</doi><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Children Colony-stimulating factor Granulocyte colony-stimulating factor Hematology Leukocytes (granulocytic) Neutropenia Oncology Pediatrics |
| title | Outcomes of Isolated Neutropenia Referred to Pediatric Hematology-Oncology Clinic |
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