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Overview of neutropenia in children and adolescents

Thomas D Coates, MD
Section Editors
E Richard Stiehm, MD
William C Mentzer, MD
Deputy Editor
Alan G Rosmarin, MD


This topic review will provide an overview of the causes, clinical manifestations, diagnosis, and management of neutropenia when it occurs as an isolated or predominant feature. Neutropenia is also a common manifestation of bone marrow defects associated with reductions in red cells and platelets, such as aplastic anemia, leukemia, myelodysplasia, megaloblastic anemia due to vitamin B12 or folate deficiency, and the administration of chemotherapy. These disorders are reviewed separately.

Laboratory evaluation of neutropenia and neutrophil function, as well as various disorders associated with neutropenia are discussed separately. (See "Laboratory evaluation of neutrophil disorders" and "Congenital neutropenia" and "Cyclic neutropenia" and "Immune neutropenia" and "Infectious causes of neutropenia" and "Drug-induced neutropenia and agranulocytosis" and "Hematologic manifestations of HIV infection: Neutropenia".)


The absolute neutrophil count (ANC) is equal to the product of the white blood cell count (WBC) and the fraction of polymorphonuclear cells (PMNs) and band forms noted on the differential analysis:

     ANC = WBC (cells/microL) x percent (PMNs  +  bands) ÷ 100

Neutrophilic metamyelocytes and younger forms are not included in this calculation (calculator 1). An ANC <1500/microL (<1.5 x 109/L) is the generally accepted definition of neutropenia for adults, as well as the threshold for neutrophil toxicity and infectious risk following chemotherapy (table 1 and table 2).

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Literature review current through: Nov 2017. | This topic last updated: Dec 14, 2015.
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