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We investigated the clinical consequences of a genetic predisposition toward lower WBC counts among 89,559 biobank participants from tertiary care centers using a polygenic score for WBC count (PGS<jats:sub>WBC<\/jats:sub>) comprising single nucleotide polymorphisms not associated with disease. A predisposition to lower WBC counts was associated with a decreased risk of identifying pathology on a bone marrow biopsy performed for a low WBC count (odds-ratio\u2009=\u20090.55 per standard deviation increase in PGS<jats:sub>WBC<\/jats:sub> [95%CI, 0.30\u22120.94], p\u2009=\u20090.04), an increased risk of leukopenia (a low WBC count) when treated with a chemotherapeutic (n\u2009=\u20091724, hazard ratio [HR]\u2009=\u20090.78 [0.69\u22120.88], p\u2009=\u20094.0\u2009\u00d7\u200910<jats:sup>\u22125<\/jats:sup>) or immunosuppressant (n\u2009=\u2009354, HR\u2009=\u20090.61 [0.38\u20130.99], p\u2009=\u20090.04). A predisposition to benign lower WBC counts was associated with an increased risk of discontinuing azathioprine treatment (n\u2009=\u20091,466, HR\u2009=\u20090.62 [0.44\u22120.87], p\u2009=\u20090.006). Collectively, these findings suggest that there are genetically predisposed individuals who are susceptible to escalations or alterations in clinical care that may be harmful or of little benefit.<\/jats:p>","DOI":"10.1038\/s41467-024-47804-5","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T06:01:52Z","timestamp":1713765712000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical associations with a polygenic predisposition to benign lower white blood cell counts"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6421-2887","authenticated-orcid":false,"given":"Jonathan D.","family":"Mosley","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Shelley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3404-3802","authenticated-orcid":false,"given":"Alyson L.","family":"Dickson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacy","family":"Zanussi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3143-5915","authenticated-orcid":false,"given":"Laura L.","family":"Daniel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil S.","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Bastarache","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4985-056X","authenticated-orcid":false,"given":"Wei-Qi","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1569-9822","authenticated-orcid":false,"given":"Mingjian","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gail P.","family":"Jarvik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6042-4487","authenticated-orcid":false,"given":"Elisabeth A.","family":"Rosenthal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6651-2725","authenticated-orcid":false,"given":"Atlas","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alborz","family":"Sherafati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-3471","authenticated-orcid":false,"given":"Iftikhar J.","family":"Kullo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-3650","authenticated-orcid":false,"given":"Theresa L.","family":"Walunas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5131-2811","authenticated-orcid":false,"given":"Joseph","family":"Glessner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2814-7461","authenticated-orcid":false,"given":"Hakon","family":"Hakonarson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy J.","family":"Cox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6302-0389","authenticated-orcid":false,"given":"Dan M.","family":"Roden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan G.","family":"Frangakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Vanderwerff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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