Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Meharry Medical College, Nashville, Tennessee, USA.
J Cell Mol Med. 2022 Jul;26(13):3628-3635. doi: 10.1111/jcmm.17346. Epub 2022 Jun 1.
Healthy individuals in the United States identified as having Black race have lower neutrophil counts, on average, than individuals identified as having White race, which could result in more negative diagnostic evaluations for neutropenia. To test this hypothesis, the proportion of evaluations where the final diagnosis was clinically insignificant neutropenia for Black and White individuals who underwent an evaluation by a haematologist that included a bone marrow (BM) biopsy to investigate neutropenia was assessed. 172 individuals without prior haematological diagnoses who underwent a haematological evaluation to investigate neutropenia. Individuals diagnosed with clinically insignificant neutropenia between Black and White individuals were compared using a propensity-score-adjusted logistic regression. Of 172 individuals, 42 (24%) were classified as Black race, 86 (50%) were males, and the 79 (46%) were over 18 years old. A BM biopsy did not identify pathology in 95% (40 of 42) of Black individuals and 68% (89 of 130) of White Individuals. Black individuals (25 of 42 [60%]) received a final diagnosis of clinically insignificant neutropenia, compared to White individuals (12 of 130 [9%]) (adjusted odds ratio =7.9, 95% CI: 3.1 - 21.1). We conclude that black individuals were more likely to receive a diagnosis of clinically insignificant neutropenia after haematological assessment.
美国健康的黑人个体的中性粒细胞计数平均低于白人个体,这可能导致对中性粒细胞减少症的诊断评估更为负面。为了验证这一假设,评估了接受血液科评估的黑人和白人个体中,最终诊断为临床意义不显著的中性粒细胞减少症的比例,该评估包括骨髓(BM)活检以调查中性粒细胞减少症。 172 名个体无先前的血液学诊断,接受了血液学评估以调查中性粒细胞减少症。使用倾向评分调整的逻辑回归比较了黑人和白人个体之间临床意义不显著的中性粒细胞减少症的诊断。在 172 名个体中,42 名(24%)被归类为黑人,86 名(50%)为男性,79 名(46%)年龄超过 18 岁。BM 活检未在 95%(40/42)的黑人个体和 68%(89/130)的白人个体中发现病理学。黑人个体(42 人中的 25 人[60%])最终诊断为临床意义不显著的中性粒细胞减少症,而白人个体(130 人中的 12 人[9%])(调整后的优势比=7.9,95%CI:3.1-21.1)。我们得出结论,在血液学评估后,黑人个体更有可能被诊断为临床意义不显著的中性粒细胞减少症。