{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:54:07Z","timestamp":1791370447088,"version":"4.3.1"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Absolute neutrophil count (ANC) guides chemotherapy dosing, treatment timing, and clinical trial eligibility throughout pediatric oncology. Duffy\u2010null\u2010associated neutrophil count (DANC) is a physiologic variant characterized by lower ANC that may be misinterpreted as treatment\u2010related neutropenia. We evaluated the implementation and clinical impact of routine serologic Duffy antigen testing in a pediatric oncology program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study of pediatric oncology patients who underwent serologic Duffy antigen testing (Fya\/Fyb phenotyping) at one institution between January 2023 and June 2026. Implementation outcomes included testing volume, laboratory workflow, turnaround time, and insurance reimbursement. Clinical utility was assessed by changes in interpretation of neutropenia or management following Duffy\u2010null identification. Duffy\u2010null patients were analyzed as an embedded case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010three patients underwent testing without additional laboratory infrastructure. Testing was integrated into the institutional blood bank workflow, with a 24\u201348\u00a0h turnaround and insurance coverage. Six patients with high\u2010risk B\u2010cell acute lymphoblastic leukemia (ALL), Down syndrome ALL, acute promyelocytic leukemia, Wilms tumor, pilocytic astrocytoma, and low\u2010grade glioma were identified as Duffy\u2010null. Before testing, these patients experienced chemotherapy delays, antimetabolite dose reductions or holds, prolonged diagnostic evaluation, or uncertainty regarding persistent neutropenia. Recognition of Duffy\u2010null status clarified interpretation of neutropenia and informed management. No infectious complications were observed following Duffy\u2010null identification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Routine serologic Duffy testing was feasible within an existing pediatric oncology program and identified clinically meaningful Duffy\u2010null status across hematologic malignancies, central nervous system (CNS) tumors, and solid tumors. These findings support prospective multicenter evaluation of Duffy\u2010informed ANC interpretation, chemotherapy delivery, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70752","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:27:48Z","timestamp":1791368868000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Routine Serologic Duffy Testing in Pediatric Oncology: Clinical Utility and Feasibility in a Single\u2010Center Cohort"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0123-301X","authenticated-orcid":false,"given":"Ipsa","family":"Mishra","sequence":"first","affiliation":[{"name":"Hackensack Meridian School of Medicine  Clifton New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1575-2192","authenticated-orcid":false,"given":"Joshua","family":"Glass","sequence":"additional","affiliation":[{"name":"Children's Cancer Institute Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center  Hackensack New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2025.3869"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30925"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.32475"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1400972"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(22)00371\u20104"},{"key":"e_1_2_8_7_1","unstructured":"U.S. Department of Health and Human Services National Institutes of Health National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 published November 27 2017 Accessed April 20 2026 https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/ctc.htm."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024014399"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddaa208"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.7467"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010023\u201039357\u2010w"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng0695\u2010224"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms1265"},{"issue":"10","key":"e_1_2_8_14_1","first-page":"625","article-title":"The Genetics of Benign Neutropenia","volume":"13","author":"Paz Z.","year":"2011","journal-title":"Israel Medical Association Journal"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31430"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.113608"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.70209"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.4671"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102025\u2010099049"},{"key":"e_1_2_8_20_1","unstructured":"\u201cAHOD2131: A Randomized Phase 3 Interim Response Adapted Trial Comparing Standard Therapy With Immuno\u2010Oncology Therapy for Children and Adults With Newly Diagnosed Stage I and II Classic Hodgkin Lymphoma \u201d ClinicalTrials.gov identifier: NCT05675410 NCT 2023 Accessed May 14 2026 https:\/\/clinicaltrials.gov\/study\/NCT05675410."},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31355"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2025029359"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022007679"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V93.9.2817.409k04_2817_2823"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.0245"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(17)30154\u20107"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.9924"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001939"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2409329"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2025.43.16_suppl.1583"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2026019827"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2026.44.16_suppl.1642"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.24.3881"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380\u2010018\u20100335\u20107"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(25)00098\u20107"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/bcp.70576"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33620"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.7326\/M21\u20104675"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024013453"},{"issue":"16","key":"e_1_2_8_40_1","first-page":"1601","article-title":"Clinical Implications and Prevalence of Benign Ethnic Neutropenia (BEN) in Breast Cancer Patients of Middle Eastern Ethnicity","volume":"43","author":"Shehata A.","year":"2025","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024014255"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djg073"}],"container-title":["Pediatric Blood &amp; 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