{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:25:57Z","timestamp":1790198757535,"version":"4.1.0"},"reference-count":89,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Determining the cause of a low neutrophil count in a pediatric or adult patient is essential for the hematologist's clinical decision-making. Fundamental to this diagnostic process is establishing the presence or lack of a mature neutrophil storage pool, as absence places the patient at higher risk for infection and the need for supportive care measures. Many diagnostic tests, eg, a peripheral blood smear and bone marrow biopsy, remain important tools, but greater understanding of the diversity of neutropenic disorders has added new emphasis on evaluating for immune disorders and genetic testing. In this article, a structure is provided to assess patients based on the mechanism of neutropenia and to prioritize testing based on patient age and hypothesized pathophysiology. Common medical quandaries including fever management, need for growth factor support, risk of malignant transformation, and curative options in congenital neutropenia are reviewed to guide medical decision-making in neutropenic patients.<\/jats:p>","DOI":"10.1182\/hematology.2021000284","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T12:16:57Z","timestamp":1639138617000},"page":"492-503","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":21,"title":["Diagnosis and therapeutic decision-making for the neutropenic patient"],"prefix":"10.1182","volume":"2021","author":[{"given":"James A.","family":"Connelly","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Walkovich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Michigan, Ann Arbor, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"issue":"1","key":"2021121012081044300_hem2021000284C1","doi-asserted-by":"crossref","first-page":"e1000360","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","year":"2009","journal-title":"PLoS Genet"},{"issue":"suppl 1","key":"2021121012081044300_hem2021000284C2","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/ijlh.13210","article-title":"How I investigate neutropenia","volume":"42","author":"Frater","year":"2020","journal-title":"Int J Lab Hematol"},{"issue":"4","key":"2021121012081044300_hem2021000284C3","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1600-0609.1981.tb00477.x","article-title":"Granulocyte demargination by epinephrine in evaluation of hypersplenic states","volume":"27","author":"Schaffner","year":"1981","journal-title":"Scand J Haematol"},{"issue":"7","key":"2021121012081044300_hem2021000284C4","doi-asserted-by":"crossref","first-page":"2591","DOI":"10.1182\/blood-2002-09-2898","article-title":"Impaired granulocytopoiesis in patients with chronic idiopathic neutropenia is associated with increased apoptosis of bone marrow myeloid progenitor cells","volume":"101","author":"Papadaki","year":"2003","journal-title":"Blood"},{"issue":"7","key":"2021121012081044300_hem2021000284C5","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1080\/14767058.2017.1401996","article-title":"How does preeclampsia affect neonates? 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