Niski poziom białych krwinek

Niski poziom białych krwinek
Epidemiologia

Leukopenia definiowana jest jako spadek liczby białych krwinek poniżej normy, tj. <4000 komórek/μl u dorosłych, z istotnym zróżnicowaniem etnicznym, gdzie u Afroamerykanów często obserwuje się łagodną neutropenię etniczną z ANC <1500/μl, niepowiązaną ze zwiększonym ryzykiem infekcji. Genetyczne determinanty, takie jak wariant genu DARC, wpływają na niższe wartości leukocytów u osób pochodzenia afrykańskiego, co ma znaczenie w kontekście ochrony przed malarią i regulacji produkcji neutrofilów. Poligeniczne predyspozycje do niskiego poziomu leukocytów korelują z ryzykiem ciężkiego przebiegu COVID-19 oraz wpływają na odpowiedź na leczenie immunosupresyjne i chemioterapię. Monitorowanie ANC, szczególnie u pacjentów onkologicznych, jest kluczowe, gdyż najniższy poziom leukocytów (nadir) pojawia się 7-10 dni po chemioterapii, a ANC <1,5 x 10^9/L wiąże się ze wzrostem ryzyka infekcji.

Epidemiologia niskiego poziomu białych krwinek

Zróżnicowanie etniczne w epidemiologii
Czynniki genetyczne w epidemiologii
Związki z chorobami w epidemiologii

Nadzór nad niskim poziomem białych krwinek

Monitorowanie kliniczne
Diagnostyka
Znaczenie dla zdrowia publicznego
Znaczenie w badaniach klinicznych
Znaczenie w diagnostyce i leczeniu chorób

Wnioski

Kolejne rozdziały

Epidemiologia niskiego poziomu białych krwinek

Niski poziom białych krwinek, nazywany medycznie leukopenią, występuje, gdy liczba krwinek białych spada poniżej normy, która dla dorosłych wynosi zazwyczaj 4000 komórek na mikrolitr krwi¹². Ocena częstości występowania leukopeniii jest złożona, ponieważ zależy ona od wielu czynników, w tym genetycznych, środowiskowych oraz współistniejących chorób³.

Zróżnicowanie etniczne w epidemiologii

Istotnym aspektem epidemiologii niskiego poziomu białych krwinek jest zróżnicowanie etniczne. Osoby pochodzenia afrykańskiego, środkowowschodniego i zachodnioindyjskiego często mają fizjologicznie niższe poziomy białych krwinek⁴⁵. Stan ten, nazywany łagodną neutropenią etniczną, charakteryzuje się mniejszą liczbą neutrofilów (poniżej 1500 na mikrolitr), ale nie wiąże się ze zwiększonym ryzykiem infekcji⁶. Szacuje się, że 25%-50% Afroamerykanów ma liczbę neutrofilów poniżej 1500 na mikrolitr, podczas gdy u mniej niż 1% białych Amerykanów występuje taki stan⁷.

Badania genomowe potwierdzają, że całkowity poziom białych krwinek i liczba neutrofilów są niższe wśród osób pochodzenia afrykańskiego z powodu powszechnego wariantu genu receptora dla chemokin antygenu Duffy (DARC)⁸. Ta genetyczna różnica zapewnia ochronę przed malarią i reguluje produkcję neutrofilów⁹.

Czynniki genetyczne w epidemiologii

Badania genomowe wykazały, że poligeniczna predyspozycja do niższego poziomu białych krwinek wpływa na różne aspekty opieki klinicznej¹⁰. W badaniu przeprowadzonym przez Continental Origins and Genetic Epidemiology Network na 16 388 Afroamerykanach zidentyfikowano różne regiony genomu związane z liczbą białych krwinek, w tym CXCL2, CDK6 i PSMD3-CSF3¹¹¹².

Badanie Population Architecture using Genomics and Epidemiology (PAGE) wykazało, że efekty genetyczne związane z liczbą białych krwinek są osłabione u Afroamerykanów i Latynosów w porównaniu z populacjami europejskimi¹³. Zidentyfikowano także sześć potencjalnie nowych odkryć dla pięciu z ośmiu badanych cech krwinek białych i płytek krwi w populacjach o zróżnicowanym pochodzeniu etnicznym¹⁴.

Związki z chorobami w epidemiologii

Niski poziom białych krwinek jest często związany z chorobami przewlekłymi lub może występować przejściowo w wyniku działania leków lub infekcji¹⁵. Choroby autoimmunologiczne, takie jak toczeń rumieniowaty układowy, stwardnienie rozsiane i reumatoidalne zapalenie stawów, wykazują genetyczne powiązanie z poziomem białych krwinek¹⁶¹⁷.

Badania wykazały również, że niższy poziom białych krwinek, niższy poziom mieloidalnych białych krwinek i niższy poziom granulocytów mogą odgrywać przyczynową rolę w zwiększaniu ryzyka ciężkiego przebiegu COVID-19¹⁸. Z kolei w przypadku pacjentów z COVID-19 wyższy poziom białych krwinek przy przyjęciu był istotnie skorelowany ze zwiększonym ryzykiem zgonu¹⁹.

Nadzór nad niskim poziomem białych krwinek

Monitorowanie poziomu białych krwinek jest kluczowym elementem opieki medycznej, szczególnie u osób z czynnikami ryzyka lub chorobami podstawowymi²⁰. Lekarze regularnie sprawdzają liczbę białych krwinek u pacjentów otrzymujących leczenie, które może powodować leukopenię, takie jak chemioterapia czy radioterapia²¹.

Monitorowanie kliniczne

U pacjentów otrzymujących chemioterapię, która często powoduje neutropenię, zespół onkologiczny może regularnie monitorować liczbę białych krwinek za pomocą badań krwi²². Całkowita liczba neutrofilów (ANC) jest używana do oceny, jak dobrze układ odpornościowy funkcjonuje podczas leczenia²³.

Nadir, czyli najniższy poziom białych krwinek po chemioterapii, występuje zwykle około 7-10 dni po otrzymaniu leczenia. Jest to okres, w którym pacjent jest najbardziej narażony na ciężkie infekcje²⁴. U osoby z neutropenią, gdy ANC jest mniejszy niż 1,5 x 10^9/L, ryzyko rozwoju infekcji wzrasta wraz ze spadkiem poziomu neutrofilów i wydłużeniem czasu utrzymywania się niskiego poziomu²⁵.

Diagnostyka

Leukopenia i neutropenia nie powodują żadnych objawów. Osoby z chorobą nowotworową zwykle dowiadują się o niskim poziomie białych krwinek z badania krwi lub gdy dojdzie do infekcji²⁶. Pełna morfologia krwi (CBC) jest podstawowym badaniem diagnostycznym, które mierzy liczbę białych krwinek oraz liczbę i proporcję każdego typu białych krwinek²⁷.

Jeżeli liczba białych krwinek lub ANC jest zbyt niska, chemioterapia jest czasami tymczasowo wstrzymywana²⁸. Jeśli chemioterapia, leki lub inne leczenie powodują neutropenię, dawka może zostać zmniejszona, leczenie zmienione lub wstrzymane do czasu regeneracji organizmu²⁹.

Znaczenie dla zdrowia publicznego

Niski poziom białych krwinek ma istotne implikacje dla zdrowia publicznego, szczególnie w kontekście chorób przewlekłych i infekcyjnych. Badania wykazały, że wysoka liczba białych krwinek jest związana ze zwiększoną śmiertelnością całkowitą i z powodu chorób serca, podczas gdy związek ze śmiertelnością z powodu nowotworów jest słabszy³⁰³¹.

W dużym badaniu kohortowym u kobiet po menopauzie wykazano, że wysoka liczba białych krwinek miała silny związek ze śmiertelnością całkowitą i z powodu chorób serca, niezależnie od wpływu palenia tytoniu³². Z kolei w badaniu EPIC-NL zaobserwowano statystycznie istotne stopniowe związki między całkowitą liczbą białych krwinek oraz liczbą limfocytów, monocytów, neutrofilów i eozynofilów a ryzykiem śmiertelności całkowitej³³.

Wyższy poziom umiarkowanej do intensywnej aktywności fizycznej (MVPA) i niższy czas siedzący były związane z niższą liczbą białych krwinek³⁴. Sugeruje to, że modyfikowalne zachowania zdrowotne mogą być związane ze stanem zapalnym poprzez liczbę białych krwinek, co może być istotne dla przyszłego ryzyka choroby³⁵³⁶.

Znaczenie w badaniach klinicznych

Liczba białych krwinek jest ważnym wskaźnikiem w badaniach klinicznych, szczególnie w kontekście chorób zakaźnych i nowotworowych. W badaniu dotyczącym sepsy wykazano, że rosnąca trajektoria liczby białych krwinek była niezależnie związana ze zwiększoną śmiertelnością (współczynnik ryzyka, 3,41; 95% przedział ufności, 1,86 do 6,26; P < 0,001) w porównaniu ze stabilną trajektorią³⁷.

W badaniach nad lekami immunosupresyjnymi, poligeniczna predyspozycja do niższego poziomu białych krwinek była związana ze zwiększonym ryzykiem przerwania leczenia azatiopryną (n=1,466, HR=0,62 [0,44–0,87], p=0,006)³⁸. Podobnie, predyspozycja do niższego poziomu białych krwinek była związana ze zmniejszonym ryzykiem identyfikacji patologii w biopsji szpiku kostnego wykonanej z powodu niskiego poziomu białych krwinek (iloraz szans=0,55 na jedno odchylenie standardowe wzrostu PGSWBC [95%CI, 0,30–0,94], p=0,04)³⁹.

Znaczenie w diagnostyce i leczeniu chorób

Niski poziom białych krwinek odgrywa istotną rolę w diagnostyce i leczeniu różnych chorób. W przypadku ciężkich pierwotnych niedoborów odporności, takich jak ciężki złożony niedobór odporności (SCID), występuje niska liczba limfocytów T i B lub ich całkowity brak, co prowadzi do zwiększonego ryzyka infekcji⁴⁰.

U osób z ciężką wrodzoną neutropenią (SCN), stosuje się czynnik stymulujący tworzenie kolonii granulocytów (G-CSF), który powoduje, że szpik kostny produkuje komórki macierzyste krwi, które dojrzewają do funkcjonujących białych krwinek⁴¹. Lek ten, opracowany przez badaczy z Memorial Sloan Kettering Cancer Center, jest stosowany na całym świecie w celu zwiększenia liczby białych krwinek u osób otrzymujących chemioterapię⁴².

W przypadku zaburzeń autoimmunologicznych, które mogą prowadzić do zniszczenia własnych białych krwinek przez przeciwciała wytworzone przez układ odpornościowy, leczenie jest ukierunkowane na podstawową chorobę⁴³⁴⁴.

Wnioski

Epidemiologia i nadzór nad niskim poziomem białych krwinek stanowią istotny element opieki zdrowotnej, szczególnie w kontekście chorób przewlekłych i infekcyjnych. Zróżnicowanie etniczne, czynniki genetyczne i związki z różnymi chorobami wpływają na częstość występowania i znaczenie kliniczne leukopeniii. Regularne monitorowanie poziomu białych krwinek, zwłaszcza u osób z czynnikami ryzyka lub poddawanych leczeniu mogącemu powodować leukopenię, jest kluczowe dla zapewnienia odpowiedniej opieki medycznej i zapobiegania powikłaniom.

Badania genetyczne dostarczają coraz więcej informacji na temat mechanizmów leżących u podstaw różnic w poziomie białych krwinek między populacjami, co może prowadzić do bardziej spersonalizowanego podejścia do diagnostyki i leczenia. Zrozumienie epidemiologii niskiego poziomu białych krwinek ma istotne implikacje dla zdrowia publicznego, badań klinicznych i praktyki medycznej.

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Materiały źródłowe

#1 Low white blood cell count
https://www.mayoclinic.org/symptoms/low-white-blood-cell-count/basics/definition/sym-20050615
A low white blood cell count is a decrease in the cells in the blood that fight disease. […] In general, for adults, a count lower than 3,500 white blood cells per microliter of blood is considered low. […] For instance, Black people tend to have lower counts than white people do.
#2 Low White Blood Cell Count (Neutropenia): What it Means
https://www.verywellhealth.com/low-white-blood-cell-count-5222890
A low white blood cell count (leukopenia) means your body has fewer white blood cells than normal, causing a weaker immune system. A blood test can help determine what is a dangerously low white blood cell count. In general, if the test shows you have less than 4,000 white blood cells per microliter of blood, it could indicate a disorder. […] A very low white blood cell count could be a symptom of a more serious condition such as hepatitis or certain types of cancer. If your white blood cell count is very low, it is important to find the underlying cause so it can be treated. […] If you have a medical condition that causes low white blood cells, its important to maintain consistent medical care. This can include getting regular blood tests to monitor your white blood cell count and surveillance for complications.
#3 Leukopenia Epidemiology: Subtypes, Symptoms, and Etiology
https://www.walshmedicalmedia.com/open-access/leukopenia-epidemiology-subtypes-symptoms-and-etiology-112730.html
Low white blood cell (leukocyte) counts are referred to medically as leukopenia. Leukopenia may, depending on its severity, significantly raise the risk of infections. […] Numerous illnesses might cause a low white blood cell count, but the first step is to determine whether there is actually a drop in the number of white blood cells. […] People with African, Middle Eastern, or West Indian ancestry frequently have apparent neutropenia due to these decreased white blood cell levels. Despite having a white blood cell count that is below normal, individuals with benign ethnic neutropenia do not have an elevated risk of infection. […] White blood cell count that appears low but is actually normal is known as leukopenia.
#4 Leukopenia Epidemiology: Subtypes, Symptoms, and Etiology
https://www.walshmedicalmedia.com/open-access/leukopenia-epidemiology-subtypes-symptoms-and-etiology-112730.html
Low white blood cell (leukocyte) counts are referred to medically as leukopenia. Leukopenia may, depending on its severity, significantly raise the risk of infections. […] Numerous illnesses might cause a low white blood cell count, but the first step is to determine whether there is actually a drop in the number of white blood cells. […] People with African, Middle Eastern, or West Indian ancestry frequently have apparent neutropenia due to these decreased white blood cell levels. Despite having a white blood cell count that is below normal, individuals with benign ethnic neutropenia do not have an elevated risk of infection. […] White blood cell count that appears low but is actually normal is known as leukopenia.
#5 Low white blood cell count
https://www.mayoclinic.org/symptoms/low-white-blood-cell-count/basics/definition/sym-20050615
A low white blood cell count is a decrease in the cells in the blood that fight disease. […] In general, for adults, a count lower than 3,500 white blood cells per microliter of blood is considered low. […] For instance, Black people tend to have lower counts than white people do.
#6 Low White Blood Cell Count: Causes and Solutions
https://www.webmd.com/cancer/white-blood-cell-count-low
Benign ethnic neutropenia: Some people have naturally low neutrophil counts of under 1,500 per microliter. It’s most often seen in people of African descent, though many people of Middle Eastern descent and a few people of European background may have it as well. This condition is called benign ethnic neutropenia because the people who have it are not at a higher risk of infection. It’s estimated that 25%-50% of African Americans have a neutrophil count of under 1,500 per microliter, while less than 1% of white Americans do. […] If you have a low WBC count, most of the time it’s nothing to worry about. However, if your count is below 4,000 per microliter, you have neutropenia, aka leukopenia, and you’ll need treatment. Treatment depends on the reason for the low WBC but generally involves giving antibiotics to fight any infections you might have. In some cases, you may need a bone marrow transplant or drugs to stimulate the production of neutrophils in your bone marrow.
#7 Low White Blood Cell Count: Causes and Solutions
https://www.webmd.com/cancer/white-blood-cell-count-low
Benign ethnic neutropenia: Some people have naturally low neutrophil counts of under 1,500 per microliter. It’s most often seen in people of African descent, though many people of Middle Eastern descent and a few people of European background may have it as well. This condition is called benign ethnic neutropenia because the people who have it are not at a higher risk of infection. It’s estimated that 25%-50% of African Americans have a neutrophil count of under 1,500 per microliter, while less than 1% of white Americans do. […] If you have a low WBC count, most of the time it’s nothing to worry about. However, if your count is below 4,000 per microliter, you have neutropenia, aka leukopenia, and you’ll need treatment. Treatment depends on the reason for the low WBC but generally involves giving antibiotics to fight any infections you might have. In some cases, you may need a bone marrow transplant or drugs to stimulate the production of neutrophils in your bone marrow.
#8 Genome-Wide Association Study of White Blood Cell Count in 16,388 African Americans: the Continental Origins and Genetic Epidemiology Network (COGENT) | PLOS Genetics
https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1002108
Total white blood cell (WBC) and neutrophil counts are lower among individuals of African descent due to the common African-derived null variant of the Duffy Antigen Receptor for Chemokines (DARC) gene. […] In order to address this, we performed a large genome-wide association study (GWAS) of total WBC and cell subtype counts in 16,388 African-American participants from 7 population-based cohorts available in the Continental Origins and Genetic Epidemiology Network. […] We demonstrate that the chromosome 16q22 association finding is most likely due to a genotyping artifact as a consequence of sequence similarity between duplicated regions on chromosomes 16q22 and 1q21. […] In summary, the CXCL2, CDK6, and PSMD3-CSF3 regions are associated with WBC count in African American and other populations.
#9 Low White Blood Cell Count: Causes and Solutions
https://www.webmd.com/cancer/white-blood-cell-count-low
A blood test that shows a WBC count of less than 4,000 per microliter (some labs say less than 4,500) could mean your body may not be able to fight infection the way it should. A low number is called leukopenia or neutropenia. Leukopenia can either be acute or chronic. […] Many people of African and Middle Eastern descent have lower WBCs than other ethnic groups. For instance, African American women may have WBC counts that are on average 25%-40% lower than those of American women of European ancestry. The difference has been linked to a genetic variant more common in people of African descent, which provides protection against malaria and also regulates the production of neutrophils. […] A very low WBC count could be due to any of the reasons below: […] Some autoimmune diseases, such as lupus and rheumatoid arthritis, will tell your body to attack and destroy its own WBCs.
#10 Clinical associations with a polygenic predisposition to benign lower white blood cell counts | Nature Communications
https://www.nature.com/articles/s41467-024-47804-5
Polygenic variation unrelated to disease contributes to interindividual variation in baseline white blood cell (WBC) counts, but its clinical significance is uncharacterized. […] 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=0.55 per standard deviation increase in PGSWBC [95%CI, 0.300.94], p=0.04), an increased risk of leukopenia (a low WBC count) when treated with a chemotherapeutic (n=1724, hazard ratio [HR]=0.78 [0.690.88], p=4.0105) or immunosuppressant (n=354, HR=0.61 [0.380.99], p=0.04). […] A predisposition to benign lower WBC counts was associated with an increased risk of discontinuing azathioprine treatment (n=1,466, HR=0.62 [0.440.87], p=0.006). […] A genetic predisposition toward benign lower WBC counts can impact clinical care.
#11 Genome-Wide Association Study of White Blood Cell Count in 16,388 African Americans: the Continental Origins and Genetic Epidemiology Network (COGENT) | PLOS Genetics
https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1002108
Total white blood cell (WBC) and neutrophil counts are lower among individuals of African descent due to the common African-derived null variant of the Duffy Antigen Receptor for Chemokines (DARC) gene. […] In order to address this, we performed a large genome-wide association study (GWAS) of total WBC and cell subtype counts in 16,388 African-American participants from 7 population-based cohorts available in the Continental Origins and Genetic Epidemiology Network. […] We demonstrate that the chromosome 16q22 association finding is most likely due to a genotyping artifact as a consequence of sequence similarity between duplicated regions on chromosomes 16q22 and 1q21. […] In summary, the CXCL2, CDK6, and PSMD3-CSF3 regions are associated with WBC count in African American and other populations.
#12 Genome-Wide Association Study of White Blood Cell Count in 16,388 African Americans: the Continental Origins and Genetic Epidemiology Network (COGENT) | PLOS Genetics
https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1002108
We also demonstrate that large inter-chromosomal duplications can result in false positive associations in GWAS. […] By examining 16,000 African Americans, we show that, in addition to the previously identified Duffy Antigen Receptor for Chemokines (DARC) locus on chromosome 1, another variant, rs9131, and other nearby variants on human chromosome 4 are associated with total WBC count in African Americans. […] The benign neutropenia of African Americans is characterized by normal myeloid maturation, but slightly reduced numbers of bone marrow myeloid progenitors and reduced numbers of mature neutrophils that can be released from bone marrow stores. […] In summary, polymorphisms within DARC on chromosome 1 and CXCL2 on chromosome 4, and near CDK6 on chromosome 7 and CSF3 on chromosome 17, are associated with WBC in African Americans.
#13 Multi-ethnic genome-wide association analyses of white blood cell and platelet traits in the Population Architecture using Genomics and Epidemiology (PAGE) study | BMC Genomics | Full Text
https://bmcgenomics.biomedcentral.com/articles/10.1186/s12864-021-07745-5
The Population Architecture using Genomics and Epidemiology (PAGE) Study funded by the National Human Genome Research Institute and the National Institute on Minority Health and Health Disparities was initiated to systematically characterize the genetic architecture underlying complex diseases and related quantitative traits among underrepresented minority populations in the U.S. through large-scale genetic epidemiological research. […] Evaluation of loci reported from a Euro-centric GWAS indicated attenuation of effect estimates in AA and HL compared to EA populations. […] Our results highlighted the potential to identify ancestry-specific and ancestry-agnostic variants in participants with diverse backgrounds and advocate for continued efforts in improving inclusion of racially/ethnically diverse populations in genetic association studies for complex traits.
#14 Multi-ethnic genome-wide association analyses of white blood cell and platelet traits in the Population Architecture using Genomics and Epidemiology (PAGE) study | BMC Genomics | Full Text
https://bmcgenomics.biomedcentral.com/articles/10.1186/s12864-021-07745-5
We identified six potential novel findings for five of the eight examined white blood cell and platelet traits in the ancestrally diverse populations from PAGE. Multiple established loci were confirmed in our analysis and independent signals were identified in six reported regions. Systematic evaluation of white blood cell and platelet traits associated loci from a Euro-centric GWAS showed global attenuation of effect sizes in AA and HL compared to EA populations. Our results indicated the importance of diversity and inclusion in genetic association studies, which will lead to an improved understanding of these complex traits.
#15 Low White Blood Cell Count (Neutropenia): What it Means
https://www.verywellhealth.com/low-white-blood-cell-count-5222890
A low white blood cell count is often a sign of chronic disease. But sometimes medications or infections can temporarily cause this problem due to the destruction of white blood cells. This should resolve once the infection clears up or the medication is discontinued. […] Diagnostic tests can identify the white blood cell count, as well as the cause of low white blood cells. A complete blood count (CBC) is a blood test that measures the number of white blood cells, as well as the number and proportion of each type of white blood cell. […] When you have a low white blood cell count, you are more susceptible to developing infections. Some ways to lower your risk of getting sick or developing an infection include the following: Practice good hygiene, such as frequent hand-washing. […] Sometimes a low white blood cell count can be treated directly, depending on the cause. Examples of treatments may include antiretroviral therapy for treating HIV or a bone marrow transplant for cancer.
#16 Genetic susceptibility for autoimmune diseases and white blood cell count | Scientific Reports
https://www.nature.com/articles/s41598-023-32799-8
Some autoimmune (AI) conditions affect white blood cell (WBC) counts. […] We developed genetic instruments for 7 AI diseases using genome-wide association study summary statistics. […] The IVWR analyses revealed significant associations between 3 AI diseases and WBC counts: systemic lupus erythematous (Beta= 0.05 [95% CI,0.06,0.03]), multiple sclerosis (Beta=0.06 [0.10,0.03]), and rheumatoid arthritis (Beta=0.02 [0.01, 0.03]). […] This study shows that genetic predisposition to systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis was associated with WBC counts, even in populations expected to have very low numbers of disease cases. […] White blood cell (WBC) counts in peripheral blood are a quantitative trait, and increased or decreased counts are part of stereotypical disease process for AI disorders.
#17 Genetic susceptibility for autoimmune diseases and white blood cell count | Scientific Reports
https://www.nature.com/articles/s41598-023-32799-8
Thus, we examined whether polygenic predictors of AI diseases were associated with WBC counts measured in large, unselected populations to test the hypothesis that for relatively rare conditions, such as AI diseases, significant associations can be detected in populations where the disease prevalence would be expected to be low based on estimates from epidemiological studies if the disease is more common than expected. […] We observed that a genetic predisposition to several AI diseases was associated with WBC counts with larger effects in females. […] In the IVWR analysis, three genetic instruments were significantly associated (P-value0.007) with WBC counts: SLE, MS, and RA. […] The change for MS was0.05 (95% CI0.07,0.02) and for RA was 0.02 (95% CI 0.01, 0.03). […] We studied the association between polygenic predictors of select AI diseases and WBC counts. […] These associations were primarily seen among women, in whom incidence rates of these diseases are known to be higher. […] In conclusion, we found that a genetic predisposition toward some AI diseases (SLE, RA and MS) was associated with either lower or higher WBC counts in multiple populations.
#18 White blood cells and severe COVID-19: a Mendelian randomization study | medRxiv
https://www.medrxiv.org/content/10.1101/2020.10.14.20212993v1.full-text
Our results suggest the potential causal effects of lower white blood cell count, lower myeloid white blood cell count, lower granulocyte count, and higher eosinophil percentage of white blood cells on an increased risk of severe COVID-19. […] Our MR analysis showed that lower white blood cell count, myeloid white blood cell count, and granulocyte count may play a causal role in increasing the risk of severe COVID-19. […] Our MR analysis supported that high eosinophil percentage of white blood cells may be causal in increasing the risk of severe COVID-19. […] Our results suggest that lower white blood cell count, lower myeloid white blood cell count, lower granulocyte count, and higher eosinophil percentage of white blood cells are causally associated with an increased risk of severe COVID-19.
#19 Correlation between white blood cell count at admission and mortality in COVID-19 patients: a retrospective study | BMC Infectious Diseases | Full Text
https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06277-3
WBC count at admission is significantly corelated with death in COVID-19 patients. Higher level of WBC count should be given more attention in the treatment of COVID-19. […] Significant association was found between WBC count and death (HR=1.14, 95%CI: 1.091.20, p0.001). […] The regression analysis results showed there was a significant association between WBC count and death (HR=5.72, 95%CI: 2.2114.82, p0.001) when use the second quartile as a cutoff value (6.1610^9/L). […] The difference was still exist after adjusting for confounding factors (HR=6.26, 95%CI: 1.7222.77, p=0.005). […] In addition, Kaplan-meier survival analysis showed that there was a significant decline of the cumulative survival rate (p0.001) in those with WBC count 6.1610^9/L. […] Our results showed that the death risk was associated with the WBC count at admission, although the index was at the normal range, those with higher WBC count patients were facing a much higher death possibility. […] In our study we had found that most of the patients were with a normal range of WBC count. However, those with higher WBC lever patients were at a high risk of death.
#20 Leukopenia: Types, Symptoms, Causes, Treatment & More
https://www.healthline.com/health/leukopenia
Several infectious diseases that can cause leukopenia include: […] Some autoimmune disorders can kill WBCs or bone marrow stem cells, which make blood cells and can lead to leukopenia. […] Certain medications can also cause leukopenia as a side effect. […] Treatment for leukopenia depends on which type of WBC is low and what’s causing it to be so. […] If you have an underlying health condition that’s causing leukopenia, such as lupus or sarcoidosis, your doctor will develop a treatment plan to manage it. […] Leukopenia usually doesn’t lead to noticeable symptoms. […] Your doctor will monitor your WBC counts carefully if you have any of the conditions that can lead to leukopenia. […] A variety of conditions can cause leukopenia, including certain types of cancer, infectious diseases, and autoimmune diseases. […] If you’re at risk of developing leukopenia, your doctor will routinely check your WBC count to help lower your chance of complications.
#21 Low White Blood Cell Counts | Neutropenia | American Cancer Society
https://www.cancer.org/cancer/managing-cancer/side-effects/low-blood-counts/neutropenia.html
People with a low white blood cell count have a condition called neutropenia. Other names for having a low white blood cell count may include leukopenia, low WBC, low leukocyte count, and being immunocompromised. […] Neutropenia can be caused by cancer, cancer treatments, or something not related to cancer. […] If chemotherapy, medicine, or other treatment is causing neutropenia, the dose might be lowered, the treatment switched, or the treatment held off until your body recovers. […] If you are getting medicine or other treatments that often cause neutropenia, your cancer care team might check your white blood cell counts with blood tests. […] Managing neutropenia depends on the cause. But if you have signs of an infection and have a low WBC count, you might be started on a treatment before they know what is causing it.
#22 Low White Blood Cell Counts | Neutropenia | American Cancer Society
https://www.cancer.org/cancer/managing-cancer/side-effects/low-blood-counts/neutropenia.html
People with a low white blood cell count have a condition called neutropenia. Other names for having a low white blood cell count may include leukopenia, low WBC, low leukocyte count, and being immunocompromised. […] Neutropenia can be caused by cancer, cancer treatments, or something not related to cancer. […] If chemotherapy, medicine, or other treatment is causing neutropenia, the dose might be lowered, the treatment switched, or the treatment held off until your body recovers. […] If you are getting medicine or other treatments that often cause neutropenia, your cancer care team might check your white blood cell counts with blood tests. […] Managing neutropenia depends on the cause. But if you have signs of an infection and have a low WBC count, you might be started on a treatment before they know what is causing it.
#23 Low White Blood Cell Counts | Neutropenia | American Cancer Society
https://www.cancer.org/cancer/managing-cancer/side-effects/low-blood-counts/neutropenia.html
Absolute neutrophil count (ANC) is the number (instead of the percentage) of neutrophils you have in a certain amount of blood. Your cancer care team will use your ANC to get an idea of how well your immune system is working during treatment. […] When the number of white blood cells goes down because of cancer treatments (especially chemotherapy), the very lowest number is called the nadir. […] The nadir usually occurs about 7 to 10 days after getting chemo. This is when a person is most at risk for a severe infection.
#24 Low White Blood Cell Counts | Neutropenia | American Cancer Society
https://www.cancer.org/cancer/managing-cancer/side-effects/low-blood-counts/neutropenia.html
Absolute neutrophil count (ANC) is the number (instead of the percentage) of neutrophils you have in a certain amount of blood. Your cancer care team will use your ANC to get an idea of how well your immune system is working during treatment. […] When the number of white blood cells goes down because of cancer treatments (especially chemotherapy), the very lowest number is called the nadir. […] The nadir usually occurs about 7 to 10 days after getting chemo. This is when a person is most at risk for a severe infection.
#25 Low white blood cell count (neutropenia) | Canadian Cancer Society
https://cancer.ca/en/treatments/side-effects/low-white-blood-cell-count
Neutropenia and leukopenia are terms used to refer to lowered numbers of white blood cells (WBCs) in the blood. WBCs help the body fight infection and disease. When WBC counts are low, there is a higher risk of infection. Not every person receiving cancer treatment will experience neutropenia or leukopenia, but many do. […] A person has leukopenia when the total WBC count is less than 3.0 x 10 9/ L. A person has neutropenia when the ANC is less than 1.9 x 10 9/ L. The risk of developing an infection is greater when the ANC is less than 1.5 x 10 9/ L. The risk increases as the neutrophil level drops and the longer it remains low. […] The risk of low white blood cell counts is greater if chemotherapy and radiation therapy are given at the same time or if large areas of bone marrow are in the radiation treatment area.
#26 Low white blood cell count (neutropenia) | Canadian Cancer Society
https://cancer.ca/en/treatments/side-effects/low-white-blood-cell-count
Leukopenia and neutropenia do not cause any symptoms. People with cancer usually find out they have low white blood cell counts from a blood test or when they get an infection. […] The healthcare team may recommend measures to reduce the effect of cancer treatments on white blood cell counts. […] If the white blood cell count or ANC is too low, chemotherapy is sometimes stopped temporarily.
#27 Low White Blood Cell Count (Neutropenia): What it Means
https://www.verywellhealth.com/low-white-blood-cell-count-5222890
A low white blood cell count is often a sign of chronic disease. But sometimes medications or infections can temporarily cause this problem due to the destruction of white blood cells. This should resolve once the infection clears up or the medication is discontinued. […] Diagnostic tests can identify the white blood cell count, as well as the cause of low white blood cells. A complete blood count (CBC) is a blood test that measures the number of white blood cells, as well as the number and proportion of each type of white blood cell. […] When you have a low white blood cell count, you are more susceptible to developing infections. Some ways to lower your risk of getting sick or developing an infection include the following: Practice good hygiene, such as frequent hand-washing. […] Sometimes a low white blood cell count can be treated directly, depending on the cause. Examples of treatments may include antiretroviral therapy for treating HIV or a bone marrow transplant for cancer.
#28 Low white blood cell count (neutropenia) | Canadian Cancer Society
https://cancer.ca/en/treatments/side-effects/low-white-blood-cell-count
Leukopenia and neutropenia do not cause any symptoms. People with cancer usually find out they have low white blood cell counts from a blood test or when they get an infection. […] The healthcare team may recommend measures to reduce the effect of cancer treatments on white blood cell counts. […] If the white blood cell count or ANC is too low, chemotherapy is sometimes stopped temporarily.
#29 Low White Blood Cell Counts | Neutropenia | American Cancer Society
https://www.cancer.org/cancer/managing-cancer/side-effects/low-blood-counts/neutropenia.html
People with a low white blood cell count have a condition called neutropenia. Other names for having a low white blood cell count may include leukopenia, low WBC, low leukocyte count, and being immunocompromised. […] Neutropenia can be caused by cancer, cancer treatments, or something not related to cancer. […] If chemotherapy, medicine, or other treatment is causing neutropenia, the dose might be lowered, the treatment switched, or the treatment held off until your body recovers. […] If you are getting medicine or other treatments that often cause neutropenia, your cancer care team might check your white blood cell counts with blood tests. […] Managing neutropenia depends on the cause. But if you have signs of an infection and have a low WBC count, you might be started on a treatment before they know what is causing it.
#30 White Blood Cell Count and Total and Cause-Specific Mortality in the Women’s Health Initiative
https://pmc.ncbi.nlm.nih.gov/articles/PMC5860271/
White blood cell (WBC) count appears to predict total mortality and coronary heart disease (CHD) mortality, but it is unclear to what extent the association reflects confounding by smoking, underlying illness, or comorbid conditions. […] High deciles of both baseline and mean WBC count were positively associated with total mortality and CHD mortality, whereas the association with cancer mortality was weaker. […] The association of WBC count with mortality was independent of smoking and did not appear to be influenced by previous disease history. […] In order to address these questions, we examined the association of WBC count with total and cause-specific mortality in the Women’s Health Initiative (WHI), a large and well-characterized cohort study of postmenopausal women with information on prevalent illness and detailed information on risk factors for chronic disease.
#31 White Blood Cell Count and Total and Cause-Specific Mortality in the Women’s Health Initiative
https://pmc.ncbi.nlm.nih.gov/articles/PMC5860271/
In this large cohort study of postmenopausal women, high WBC count showed robust associations with total mortality and CHD mortality and a weaker association with cancer mortality. […] Our data provide convincing evidence that high WBC counts are associated with increased all-cause and CHD mortality in otherwise healthy postmenopausal women, and that the association is independent of the effects of smoking.
#32 White Blood Cell Count and Total and Cause-Specific Mortality in the Women’s Health Initiative
https://pmc.ncbi.nlm.nih.gov/articles/PMC5860271/
In this large cohort study of postmenopausal women, high WBC count showed robust associations with total mortality and CHD mortality and a weaker association with cancer mortality. […] Our data provide convincing evidence that high WBC counts are associated with increased all-cause and CHD mortality in otherwise healthy postmenopausal women, and that the association is independent of the effects of smoking.
#33 White cell counts in relation to mortality in a general population of cohort study in the Netherlands: a mediating effect or not? | BMJ Open
https://bmjopen.bmj.com/content/9/10/e030949
White cell count (WCC) is a clinical marker of inflammation. Data are limited regarding the association of total and differential WCC with risk of mortality, and its role related with smoking and body mass index (BMI). […] After an average follow-up of 15.8 years, a total of 936 death cases were identified (466 cancer; 179 CVD; 291 other causes). Statistically significant graded associations between total WCC, and counts of lymphocytes, monocytes, neutrophils and eosinophils and risk of total mortality were observed. These associations were more apparent in current smokers. Strong associations for all-cause mortality or cancer mortality were observed in subjects with BMI 25 kg/m2, ever smoking and elevated WCC (HR 3.92, 95%CI 2.76 to 5.57; HR 3.93, 95%CI 2.30 to 6.72). WCC partly mediated the associations between smoking or BMI and all-cause mortality.
#34 Association of physical activity and sedentary time with blood cell counts: National Health and Nutrition Survey 2003-2006 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204277
Higher levels of moderate-vigorous physical activity (ptrend0.001) and lower sedentary time (ptrend = 0.040) were associated with lower white blood cell counts. […] These results suggest that modifiable health behaviors, such as physical activity and sedentary time, may be associated with inflammatory status through white blood cell counts, which may be important for future disease risk. […] Our study shows that blood cell counts, in particular WBCs, differ based on activity level in a nationally representative sample of U.S. adults. […] Levels of WBCs appear to be particularly sensitive to both MVPA and sedentary time in a dose dependent manner. […] After controlling for available covariates known to be associated with altered blood counts, our finding that adults with greater MVPA and lower sedentary time have lower counts of WBCs are consistent with other studies that have shown that WBCs are reduced in elderly adult populations who have higher levels of MVPA.
#35 Association of physical activity and sedentary time with blood cell counts: National Health and Nutrition Survey 2003-2006 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204277
Higher levels of moderate-vigorous physical activity (ptrend0.001) and lower sedentary time (ptrend = 0.040) were associated with lower white blood cell counts. […] These results suggest that modifiable health behaviors, such as physical activity and sedentary time, may be associated with inflammatory status through white blood cell counts, which may be important for future disease risk. […] Our study shows that blood cell counts, in particular WBCs, differ based on activity level in a nationally representative sample of U.S. adults. […] Levels of WBCs appear to be particularly sensitive to both MVPA and sedentary time in a dose dependent manner. […] After controlling for available covariates known to be associated with altered blood counts, our finding that adults with greater MVPA and lower sedentary time have lower counts of WBCs are consistent with other studies that have shown that WBCs are reduced in elderly adult populations who have higher levels of MVPA.
#36 Association of physical activity and sedentary time with blood cell counts: National Health and Nutrition Survey 2003-2006 | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204277
Data collected on WBCs collectively suggest that activity may modulate the inflammatory environment by altering the cellular composition in peripheral blood, which may contribute to risk of disease development. […] Overall our study suggests that active individuals may maintain a lower inflammatory state through altered levels of WBCs. This may contribute to a lower risk of future chronic disease development and provides a potential mechanism to explain the health benefits associated with physical activity.
#37
https://link.springer.com/article/10.1007/s12630-022-02282-5
Septic shock is associated with a mortality of 20-40%. The white blood cell count (WBC) at hospital admission correlates with prognosis in septic shock. […] A rising WBC trajectory was independently associated with increased mortality (hazard ratio, 3.41; 95% confidence interval, 1.86 to 6.26; P 0.001) compared with the stable WBC trajectory. […] In patients with septic shock, distinct and clinically relevant groups can be identified by analyzing WBC trajectories. A rising WBC trajectory was associated with higher mortality.
#38 Clinical associations with a polygenic predisposition to benign lower white blood cell counts | Nature Communications
https://www.nature.com/articles/s41467-024-47804-5
Polygenic variation unrelated to disease contributes to interindividual variation in baseline white blood cell (WBC) counts, but its clinical significance is uncharacterized. […] 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=0.55 per standard deviation increase in PGSWBC [95%CI, 0.300.94], p=0.04), an increased risk of leukopenia (a low WBC count) when treated with a chemotherapeutic (n=1724, hazard ratio [HR]=0.78 [0.690.88], p=4.0105) or immunosuppressant (n=354, HR=0.61 [0.380.99], p=0.04). […] A predisposition to benign lower WBC counts was associated with an increased risk of discontinuing azathioprine treatment (n=1,466, HR=0.62 [0.440.87], p=0.006). […] A genetic predisposition toward benign lower WBC counts can impact clinical care.
#39 Clinical associations with a polygenic predisposition to benign lower white blood cell counts | Nature Communications
https://www.nature.com/articles/s41467-024-47804-5
Polygenic variation unrelated to disease contributes to interindividual variation in baseline white blood cell (WBC) counts, but its clinical significance is uncharacterized. […] 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=0.55 per standard deviation increase in PGSWBC [95%CI, 0.300.94], p=0.04), an increased risk of leukopenia (a low WBC count) when treated with a chemotherapeutic (n=1724, hazard ratio [HR]=0.78 [0.690.88], p=4.0105) or immunosuppressant (n=354, HR=0.61 [0.380.99], p=0.04). […] A predisposition to benign lower WBC counts was associated with an increased risk of discontinuing azathioprine treatment (n=1,466, HR=0.62 [0.440.87], p=0.006). […] A genetic predisposition toward benign lower WBC counts can impact clinical care.
#40 Primary Immunodeficiencies (PIDs), Primary Immune Regulatory Disorders (PIRDs) and White Blood Cell Disorders | Memorial Sloan Kettering Cancer Center
https://www.mskcc.org/pediatrics/cancer-care/types/pediatric-blood-disorders/about-pediatric-blood-disorders/primary-immunodeficiencies-pids-primary-immune-regulatory-disorders-pirds-and-white-blood-cell-disorders
There are several types of immunodeficiencies, also known as immune disorders or immune deficiencies. These rare genetic disorders that prevent the body from having the right immune response to fight an infection. […] Primary immunodeficiencies (PIDs) lower the number of immune cells, which fight infection. This makes it harder for your child’s body to fight infections. […] A primary immunodeficiency (PID) is a condition where there are low numbers of immune cells, or none at all. Immune cells include T cells and B cells, which are important white blood cells for immunity. Primary immune deficiencies are genetic disorders that can have more than 350 different genetic causes. […] Severe combined immunodeficiency (SCID) is a genetic disorder. It can make your child have a low number of T cells and B cells, or none at all. These immune cells fight against infection. Different types of immune cells, such as T cells and B cells, have their own specialized job. SCID lowers the number of normal, healthy white blood cells and other immune cells. That makes it more likely a child will get infections.
#41 Primary Immunodeficiencies (PIDs), Primary Immune Regulatory Disorders (PIRDs) and White Blood Cell Disorders | Memorial Sloan Kettering Cancer Center
https://www.mskcc.org/pediatrics/cancer-care/types/pediatric-blood-disorders/about-pediatric-blood-disorders/primary-immunodeficiencies-pids-primary-immune-regulatory-disorders-pirds-and-white-blood-cell-disorders
Chronic benign neutropenia (CBN) is also known as chronic idiopathic neutropenia or autoimmune neutropenia. […] Neutrophils are a type of white blood cell that fight back against infection. […] Severe congenital neutropenia (SCN) may also be known as Severe Chronic Neutropenia or Kostmann Syndrome. Children with SCN develop serious infections as early as infancy or later in life. This inherited disorder is caused by a genetic mutation and leads to very low levels of white blood cells called neutrophils. […] We use a drug called granulocyte colony-stimulating factor, or G-CSF, to treat SCN. It makes the bone marrow produce blood stem cells that mature into functioning white blood cells. Memorial Sloan Kettering Cancer Center researchers developed G-CSF, which has been used around the world to raise white blood cell counts in people receiving chemotherapy. It is also effective in many children with low white blood cell counts. […] No matter which treatment we recommend, we monitor all children for non-Hodgkin lymphoma, a cancer that starts in the white blood cells. Hyper IgM puts children at higher risk for this disease.
#42 Primary Immunodeficiencies (PIDs), Primary Immune Regulatory Disorders (PIRDs) and White Blood Cell Disorders | Memorial Sloan Kettering Cancer Center
https://www.mskcc.org/pediatrics/cancer-care/types/pediatric-blood-disorders/about-pediatric-blood-disorders/primary-immunodeficiencies-pids-primary-immune-regulatory-disorders-pirds-and-white-blood-cell-disorders
Chronic benign neutropenia (CBN) is also known as chronic idiopathic neutropenia or autoimmune neutropenia. […] Neutrophils are a type of white blood cell that fight back against infection. […] Severe congenital neutropenia (SCN) may also be known as Severe Chronic Neutropenia or Kostmann Syndrome. Children with SCN develop serious infections as early as infancy or later in life. This inherited disorder is caused by a genetic mutation and leads to very low levels of white blood cells called neutrophils. […] We use a drug called granulocyte colony-stimulating factor, or G-CSF, to treat SCN. It makes the bone marrow produce blood stem cells that mature into functioning white blood cells. Memorial Sloan Kettering Cancer Center researchers developed G-CSF, which has been used around the world to raise white blood cell counts in people receiving chemotherapy. It is also effective in many children with low white blood cell counts. […] No matter which treatment we recommend, we monitor all children for non-Hodgkin lymphoma, a cancer that starts in the white blood cells. Hyper IgM puts children at higher risk for this disease.
#43 Azthena logo with the word Azthena
https://www.news-medical.net/health/Determining-Disease-Through-White-Blood-Cells.aspx
Leukopenia is a decrease in the number of white blood cells to fewer than 4,000 cells per microliter of blood. […] Low white cell counts may be caused by the underproduction of white cells in the bone marrow, sometimes following exposure to chemicals like benzene, or due to primary or secondary malignancies. The treatment of cancers by chemotherapy or radiation can also cause leukopenia due to reduced bone marrow synthesis of these cells. […] Autoimmune disorders such as systemic lupus erythematosus, or rheumatoid arthritis, can also lead to the destruction of the body’s own white cells by antibodies created by the immune system. […] Viral infections may also cause leukopenia, usually because of the rapid consumption of white cells faster than the rate of their production in the bone marrow. The human immunodeficiency virus (HIV) is known to target one type of lymphocyte, bearing the CD4 marker, leading to profound immunodeficiency.
#44 Leukopenia: Types, Symptoms, Causes, Treatment & More
https://www.healthline.com/health/leukopenia
Several infectious diseases that can cause leukopenia include: […] Some autoimmune disorders can kill WBCs or bone marrow stem cells, which make blood cells and can lead to leukopenia. […] Certain medications can also cause leukopenia as a side effect. […] Treatment for leukopenia depends on which type of WBC is low and what’s causing it to be so. […] If you have an underlying health condition that’s causing leukopenia, such as lupus or sarcoidosis, your doctor will develop a treatment plan to manage it. […] Leukopenia usually doesn’t lead to noticeable symptoms. […] Your doctor will monitor your WBC counts carefully if you have any of the conditions that can lead to leukopenia. […] A variety of conditions can cause leukopenia, including certain types of cancer, infectious diseases, and autoimmune diseases. […] If you’re at risk of developing leukopenia, your doctor will routinely check your WBC count to help lower your chance of complications.