Clinical spectrum of neutropenia in children — analysis of 109 cases

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Introduction: The aim of this study is to retrospectively analyze the course of neutropenia in children hospitalized at a single pediatric hematology and oncology center with particular emphasis on the assessment of risk factors for severe infectious complications. Material and methods: The study included 109 children diagnosed with neutropenia unrelated to malignancy. The etiology, laboratory and genetic test results, and clinical data and course were analyzed. Results: More than half of the patients were ultimately diagnosed with benign childhood neutropenia (53.2%). 74.5% of children presented a chronic course of neutropenia, with a mean duration of 22 months. The duration of neutropenia had a significant impact on its clinical course — none of the patients with acute neutropenia had severe infections or the need for treatment. Among patients with chronic neutropenia, a positive family history (p <0.002), comorbidities (p <0.005), severe infectious complications (p<0.001) and the need for specific treatment (p <0.004) were observed statistically more often in children with congenital form of the disease. Conclusions: Neutropenia in children usually has a benign course, but the prognosis largely depends on duration and etiology. History, clinical course, and ancillary test results should be carefully interpreted to identify patients with congenital neutropenia, due to the higher risk of complications and the need to treat patients in this group.