Absolute neutrophil count by Duffy status among healthy Black and African American adults

Author:

Merz Lauren E.1ORCID,Story Charlotte M.1ORCID,Osei Miriam A.1,Jolley Katherine2,Ren Siyang3,Park Hae Soo2,Yefidoff Freedman Revital2,Neuberg Donna3,Smeland-Wagman Robin4,Kaufman Richard M.4,Achebe Maureen O.2ORCID

Affiliation:

1. 1Department of Internal Medicine, Brigham and Women’s Hospital, Boston, MA

2. 3Division of Hematology, Brigham and Women’s Hospital, Boston, MA

3. 2Department of Data Science, Dana-Farber Cancer Institute, Boston, MA

4. 4Department of Pathology, Brigham and Women’s Hospital, Boston, MA

Abstract

AbstractMany people of African ancestry have lower absolute neutrophil counts (ANCs) without increased risk for infection. This is associated with the Duffy-null phenotype (nonexpression of the Duffy antigen on red blood cells), which is commonly found in those of African descent. Currently, there are no studies that compare the ANC of individuals with Duffy-null phenotype to those with Duffy non-null phenotypes within a self-identified Black population. The aim of this study was to assess the impact of Duffy status on ANCs based on complete blood counts with differential and Duffy testing in a healthy population of self-identified Black individuals at a single primary care center. This study found that 66.7% (80 of 120) of Black individuals have the Duffy-null phenotype and that there is a significant difference in ANCs between Duffy-null and Duffy non-null individuals (median, 2820 cells per μL vs 5005 cells per μL; P < .001). Additionally, 19 of 80 (23.8%) Duffy-null individuals had an ANC of <2000 cells per μL compared with no (0) Duffy non-null individuals. The Duffy-null phenotype is clinically insignificant; however, inappropriate reference ranges can propagate systemic racism. Therefore, we advocate for the development of Duffy-null–specific ANC reference ranges as well as replacing the term benign ethnic neutropenia with Duffy-nullassociated neutrophil count.

Publisher

American Society of Hematology

Subject

Hematology

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