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September 1993

New Developments in the Treatment of Neutropenia

Author Affiliations

From the Departments of Pediatrics, Cornell Medical Center and Memorial Sloan-Kettering Cancer Center, New York, NY.

Am J Dis Child. 1993;147(9):994-1000. doi:10.1001/archpedi.1993.02160330084026

Increased attention has been devoted to the management of neutropenia during the last 2 to 4 years. In this review we will discuss the introduction of effective novel therapies: hematopoietic growth factors (HGFs) for many forms of persistent neutropenia and intravenous (IV) immune globulin for autoimmune neutropenia (AIN).

Neutropenia is defined as a subnormal absolute number of neutrophils circulating in the blood. Determination of the absolute neutrophil count (ANC) requires the combination of a white blood cell (WBC) count and a differential WBC count. For example, if the WBC count is 8.0×109/L and the differential WBC count indicates 0.20 neutrophils, the ANC=8.0×0.20, or 1.6. Since the differential WBC count defines neutropenia, it is important that a hematologist review the blood smear and that an automated count not be exclusively relied on. The exact definition of the boundary between a normal ANC and neutropenia has ranged between 1.5 and