Abstract:

Neutropenia, defined as an absolute neutrophil count (ANC) below 1.5 × 109/L, encompasses a wide range of diagnoses, from normal variants to life-threatening acquired and congenital disorders.The prevalence of neutropenia and associated hematological parameters in Arab males and females coming for blood donation was not studied before in Qatar.

Neutropenia, usually defined as an absolute neutrophil count (ANC) below 1.5 × 109/L (1500/mm3), encompasses a wide range of diagnoses, from normal variants to life-threatening acquired and congenital disorders. The functional consequences depend largely, but not exclusively, on the severity of neutropenia. ANC of 1.0-1.5 × 109/L does not impair host defence but may warrant investigation of the underlying cause. However, ANC of 0.5-1.0 × 109/L may slightly increase the risk of infections, but only if other arms of the immune system are impaired. ANC of 0.2-0.5 × 109/L is associated with an increased risk of infections in most patients. ANC of 0.2 × 109/L or less (often referred to as "agranulocytosis") carries a risk of severe, life-threatening infections with susceptibility to opportunistic organisms. Healthy Caucasian and Asian populations generally have ANCs of 1.5 to 7.0 × 109/L. Persons of African descent, however, may have lower normal neutrophil counts, with ANC <1.5 × 109/L occurring in about 4.5% of black participants in one U.S. survey. It was once thought that neutrophil levels fluctuate cyclically in the normal person, but best evidence now indicates that levels fluctuate considerably but do not normally cycle in a mathematically regular fashion.

Aim and Objective:

To provide baseline information regarding the prevalence and spectrum of neutropenia in random large samples (n = 600) of non-prospective Arab blood donors.

Materials and Methods:

Complete blood count (CBC) of all non-prospective blood donors (n =600) was performed in 600 Arab healthy Adults (Age >18 years to < 65 years)using automated analyzer for evaluation of white and red blood cell indices.Haemoglobin concentration was determined using the Coulter LH 750, Advia 2120/120 or Sysmex XE 5000/2100 cell counter.

Results:

The prevalence of Neutropenia (ANC) below 1.5 × 109/L)in 600 non-prospective adult Arab blood donors (200 females and 400 males, age >18 y : <65 y)) was 10.7%. The prevalence in females was 32 % and in males was 6 %. ANC below 1× 109/Lwas detected in 10 % of Arab females and 1.8 % of Arab males. Neutropenia was significantly higher in healthy adult Arab females compared with males.In females, the neutropenic groupgroup had significantly lower Hb level and higher RDW, and lower total WBC and lymphocyte counts (p <0.001) compared to the group with ANC > 1.5× 109/L.In males, the neutropenic grouphad significantly lower Hb level and hematocrit value, and lower total WBC, lymphocyte, and basophil counts (p <0.001) compared to the group with ANC > 1.5× 109/L. Significant correlations were found between the ANC and Hb (r = 0.33, p < 0.05) and ANC and total WBC (r = 0.45, P < 0.01).

Conclusion:

The prevalence of neutropenia is considerably high in Arab adult females compared to other ethnic groups and it is significantly higher in females compared to males. Besides the genetic constitution for Arabs , the lower Hb and high RDW in females with neutropenia suggested that iron deficiency is factor in the production of this neutropenia.

Key words: Prevalence, Neutropenia, Anemia, Adults, Arabs, ANC.

Disclosures

No relevant conflicts of interest to declare.

Author notes

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Asterisk with author names denotes non-ASH members.

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