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Prolonged acquired neutropenia in children.

AbstractBACKGROUND:
Acquired neutropenia is not uncommon in childhood. This study investigated the risk factors associated with developing prolonged acquired neutropenia.
PROCEDURE:
We reviewed 66,062 hospital admission medical records from the 5-year period January 1, 2002 to December 31, 2006 to identify neutropenic patients, with and without follow-up of their neutropenic course until December 31, 2007. After excluding patients with malignancy, collagen disease, bone marrow failure, prematurity, hereditary disease, congenital neutropenia, immunodeficiency, or status post-liver transplantation, 735 admissions with acquired neutropenia were included in our study.
RESULTS:
A total of 474 patients with 735 admissions had moderate or severe neutropenia during the 5-year period. Among the 252 acquired neutropenia patients who had follow-up for at least 1 month, 226 patients recovered within 3 months, while 26 patients remained neutropenic after 3 months. Of these 26 patients, 14 recovered after 1 year. An absolute neutrophil count of <500/mm(3) (odds ratio [OR]: 13.66, 95% confidence interval [CI]: 2.90-64.41), thrombocytosis (OR: 5.76, 95% CI: 1.78-18.58), and age <1 year (OR: 4.93, 95% CI: 1.03-23.54) were associated with prolonged acquired neutropenia, as shown by multivariate logistic regression. Kaplan-Meier analysis showed that neutropenia associated with cytomegalovirus (CMV) was more prolonged than neutropenia associated with influenza or Epstein-Barr virus infection.
CONCLUSIONS:
Prolonged acquired neutropenia was associated with younger age, thrombocytosis, and CMV infection. Neutropenic infants with CMV infection may require antiviral therapy to prevent prolonged acquired neutropenia.
AuthorsJiunn-Ming Sheen, Ho-Chang Kuo, Hong-Ren Yu, Eng-Yen Huang, Chih-Chiang Wu, Kuender D Yang
JournalPediatric blood & cancer (Pediatr Blood Cancer) Vol. 53 Issue 7 Pg. 1284-8 (Dec 15 2009) ISSN: 1545-5017 [Electronic] United States
PMID19711442 (Publication Type: Journal Article)
Copyright(c) 2009 Wiley-Liss, Inc.
Topics
  • Age Factors
  • Bacterial Infections (blood, epidemiology, immunology)
  • Bronchopneumonia (blood, epidemiology, immunology)
  • Child
  • Child, Preschool
  • Convalescence
  • Cytomegalovirus Infections (blood, epidemiology, immunology)
  • Disease Susceptibility
  • Epstein-Barr Virus Infections (blood, epidemiology, immunology)
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Influenza, Human (blood, epidemiology, immunology)
  • Male
  • Neutropenia (epidemiology, etiology, microbiology, virology)
  • Patient Admission (statistics & numerical data)
  • Risk Factors
  • Taiwan (epidemiology)
  • Thrombocytosis (epidemiology, etiology)
  • Time Factors

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