{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:20:54Z","timestamp":1788261654785,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":["Int J Lab Hematology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The absence of Duffy antigen expression on red blood cells, caused by a single nucleotide polymorphism in the DARC\/ACKR1 gene, confers protection against malaria and is associated with lower absolute neutrophil counts (ANC) in some studied populations. This study aimed to establish reference intervals for ANC and evaluate other hematologic parameters influenced by Duffy status in Brazilian individuals. In this prospective study, complete blood counts and Duffy phenotyping were performed in 311 healthy adult blood donors from two independent blood banks. Among participants, 51.4% were male, with a median age of 37\u2009years, and 46.6% self\u2010identified as Black or mixed\u2010race. The Duffy null phenotype was observed in 146 individuals (46.9%), with lower male representation and higher prevalence among Black individuals. Duffy null individuals showed lower median white blood cell counts (5350 vs. 7060\/\u03bcL) and ANC (median 2250 vs. 4070\/\u03bcL), with a 95% reference range of 1180\u20134800\/\u03bcL versus 2200\u20137250\/\u03bcL. They also had a lower neutrophil percentage and higher relative counts of other leukocytes, without differences in absolute lymphocytes and eosinophils. Additionally, they exhibited higher erythrocyte counts, hemoglobin, hematocrit, platelet counts, and mean platelet volume. These findings support Duffy\u2010specific reference intervals to avoid misclassification in diverse populations like Brazil.<\/jats:p>","DOI":"10.1111\/ijlh.70235","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:11:16Z","timestamp":1788261076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Blood Cell Counts and the Duffy Null Phenotype: Beyond Neutropenia"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9707-0579","authenticated-orcid":false,"given":"Elvira Deolinda R. P.","family":"Velloso","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"},{"name":"Universidade de S\u00e3o Paulo, Hospital das Cl\u00ednicas, Faculdade de Medicina  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0783-4320","authenticated-orcid":false,"given":"Andreza Oliveira","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0453-7863","authenticated-orcid":false,"given":"Carla Luana","family":"Dinardo","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5103-4970","authenticated-orcid":false,"given":"Carolina Bonet","family":"Bub","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7398-1546","authenticated-orcid":false,"given":"Leandro Dinalli","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8123-8242","authenticated-orcid":false,"given":"Mauren Fernanda Moller","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Carlos","family":"de Campos Guerra","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0588-392X","authenticated-orcid":false,"given":"Denise dos Anjos Laurentis de Sousa","family":"Campos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica Juliana","family":"Vieira","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9094-4763","authenticated-orcid":false,"given":"F\u00e1bio Julio","family":"da Luz","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Mendrone\u2010Junior","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1730-9066","authenticated-orcid":false,"given":"Rosana M.","family":"Cosentino Penteado","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"issue":"10","key":"e_1_2_12_2_1","first-page":"625","article-title":"The Genetics of Benign Neutropenia","volume":"13","author":"Paz Z.","year":"2011","journal-title":"Israel Medical Association Journal"},{"issue":"3","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1532\/LH96.09005","article-title":"Ethnic and Genetic Causes of Neutropenia: Clinical and Therapeutic Implications","volume":"15","author":"D'Angelo G.","year":"2009","journal-title":"Laboratory Hematology"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgen.1000360","article-title":"Reduced Neutrophil Count in People of African Descent Is due to a Regulatory Variant in the Duffy Antigen Receptor for Chemokines Gene","volume":"5","author":"Reich D.","year":"2009","journal-title":"PLoS Genetics"},{"issue":"23","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"2088","DOI":"10.1001\/jama.2023.7467","article-title":"Development of Duffy Null\u2010Specific Absolute Neutrophil Count Reference Ranges","volume":"329","author":"Merz L. E.","year":"2023","journal-title":"Journal of the American Medical Association"},{"issue":"6","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1111\/ijlh.12712","article-title":"Duffy Null Genotype or Fy(a\u2010b\u2010) Phenotype Are More Accurate Than Self\u2010Declared Race for Diagnosing Benign Ethnic Neutropenia in Brazilian Population","volume":"39","author":"Dinardo C. L.","year":"2017","journal-title":"International Journal of Laboratory Hematology"},{"key":"e_1_2_12_7_1","unstructured":"\u201cPortaria de Consolida\u00e7\u00e3o n\u00ba 05 de 28 de Setembro de 2017 \u201dhttps:\/\/www.gov.br\/saude\/pt\u2010br\/assuntos\/saude\u2010de\u2010a\u2010a\u2010z\/s\/saude\u2010da\u2010pessoa\u2010com\u2010deficiencia\/legislacao\/portaria\u2010de\u2010consolidacao\u2010no\u201005\u2010de\u201028\u2010de\u2010setembro\u2010de\u20102017.pdf\/view."},{"key":"e_1_2_12_8_1","volume-title":"Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory","author":"CLSI","year":"2010"},{"issue":"9","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1056\/NEJMms2004740","article-title":"Hidden in Plain Sight \u2010 Reconsidering the Use of Race Correction in Clinical Algorithms","volume":"383","author":"Vyas D. A.","year":"2020","journal-title":"New England Journal of Medicine"},{"issue":"1","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1053\/lc.1999.v133.a94931","article-title":"Benign Ethnic Neutropenia: What Is a Normal Absolute Neutrophil Count?","volume":"133","author":"Haddy T. B.","year":"1999","journal-title":"Journal of Laboratory and Clinical Medicine"},{"issue":"7","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1038\/ni.3763","article-title":"Atypical Chemokine Receptor 1 on Nucleated Erythroid Cells Regulates Hematopoiesis","volume":"18","author":"Duchene J.","year":"2017","journal-title":"Nature Immunology"},{"key":"e_1_2_12_12_1","volume-title":"Blood Groups and Red Cell Antigens","author":"Dean L.","year":"2005"},{"issue":"4","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.htct.2020.08.015","article-title":"Duffy Phenotyping and FY*B\u201067T\/C Genotyping as Screening Test for Benign Constitutional Neutropenia","volume":"43","author":"Barreto M. E. S. F.","year":"2021","journal-title":"Hematology, Transfusion and Cell Therapy"},{"issue":"5","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1111\/bjh.19758","article-title":"Genetic Variants Associated With White Blood Cell Count Amongst Individuals With Sickle Cell Disease","volume":"205","author":"Cintho Ozahata M.","year":"2024","journal-title":"British Journal of Haematology"},{"issue":"9","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.32475","article-title":"Cancer Trial Eligibility and Therapy Modifications for Individuals With Duffy Null\u2010Associated Neutrophil Count","volume":"7","author":"Hibbs S. P.","year":"2024","journal-title":"JAMA Network Open"},{"issue":"3","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1182\/bloodadvances.2022007679","article-title":"Absolute Neutrophil Count by Duffy Status Among Healthy Black and African American Adults","volume":"7","author":"Merz L. E.","year":"2023","journal-title":"Blood Advances"},{"issue":"3","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1182\/blood.2025029359","article-title":"Multinational Assessment of Absolute Neutrophil Counts and White Blood Cell Counts Among Healthy Duffy\u2010Null Adults","volume":"147","author":"Hibbs S. P.","year":"2026","journal-title":"Blood"},{"issue":"1","key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1182\/blood.2020008600","article-title":"When Non\u2010Whiteness Becomes a Condition","volume":"137","author":"Merz L. E.","year":"2021","journal-title":"Blood"},{"issue":"11","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2025-099049","article-title":"Duffy\u2010Null Variant and Practical Implications for Patient Care: A Scoping Review","volume":"15","author":"Asiimwe E.","year":"2025","journal-title":"BMJ Open"},{"issue":"1","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.31430","article-title":"Clinical and Laboratory Characteristics of Pediatric Patients With ACKR1\/DARC\u2010Associated Neutropenia","volume":"72","author":"Oz\u2010Alcalay L.","year":"2025","journal-title":"Pediatric Blood & Cancer"},{"issue":"6","key":"e_1_2_12_21_1","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.31693","article-title":"Prevalence of Duffy Null and Its Impact on Hydroxyurea Dosing in Children With Sickle Cell Disease","volume":"72","author":"Menell J. S.","year":"2025","journal-title":"Pediatric Blood & Cancer"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.psychres.2024.116146","article-title":"Duffy\u2010Null Associated Neutrophil Count and Antipsychotic Use","volume":"340","author":"Bera S.","year":"2024","journal-title":"Psychiatry Research"},{"issue":"1","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s10549-025-07856-7","article-title":"Exploring the Effect of Duffy Status on Patients With Breast Cancer Receiving Cyclin\u2010Dependent Kinase 4\/6 Inhibitors","volume":"215","author":"Ferri G. M.","year":"2025","journal-title":"Breast Cancer Research and Treatment"},{"issue":"8","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1001\/jamainternmed.2021.3108","article-title":"Association Between a Common, Benign Genotype and Unnecessary Bone Marrow Biopsies Among African American Patients","volume":"181","author":"Van Driest S. L.","year":"2021","journal-title":"JAMA Internal Medicine"},{"key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijid.2023.12.005","article-title":"Higher Platelet Counts and Platelet Factors Are Associated With a Reduction in Plasmodium Falciparum Parasite Density in Young Malian Children","volume":"139","author":"Attaher O.","year":"2024","journal-title":"International Journal of Infectious Diseases"}],"container-title":["International Journal of Laboratory Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.70235","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijlh.70235","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.70235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:11:21Z","timestamp":1788261081000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijlh.70235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":24,"alternative-id":["10.1111\/ijlh.70235"],"URL":"https:\/\/doi.org\/10.1111\/ijlh.70235","archive":["Portico"],"relation":{},"ISSN":["1751-5521","1751-553X"],"issn-type":[{"value":"1751-5521","type":"print"},{"value":"1751-553X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"assertion":[{"value":"2026-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijlh.70235"}}