Advertisement

Lower Total Leukocyte and Neutrophil Counts in Healthy Young Africans from Uganda

  • Ritesh Goswami
  • Naveen Kakkar
  • M. Joseph John
Original Article

Abstract

The total leukocyte count (TLC) is an important component of the complete blood count and influences many clinical decisions. The effect of race or ethnicity on TLC is not well known. The African population has been reported to have lower than normal TLC and neutrophil counts. In this study, thirty eight African students referred for medical check up to a tertiary care hospital were included. Complete blood count was done on a three part automated hematology analyzer. Blood smear examination and manual differential count was also done. The control group included 38 age and sex matched healthy individuals. Student t test was used to compare the differences between the groups. The mean TLC in African students (4.95 ± 1.09 × 109/l) was significantly lower (p < 0.0001) than that seen in the control group (7.42 ± 1.7 × 109/l). The mean neutrophil percentage was also lower (49 ± 7.5%) in African students compared to the control group (63.6 ± 9.8%) [p < 0.0001] while lymphocyte percentage was higher (45.2 ± 7.5%) in the African students as compared to the control group (31.0 ± 9.3%) [p < 0.0001]. Absolute neutrophil count was also lower (2.45 ± 0.76 × 109/l) in African students compared to the control group (4.76 ± 1.47 × 109/l) while absolute lymphocyte count was comparable (2.21 ± 0.5 × 109/l vs. 2.26 ± 0.72 × 109/l) [p = 0.7212]. This study has shown lower leukocyte and neutrophil counts in apparently healthy African individuals. Knowledge of this variation from normal white cell and neutrophil counts is important in avoiding unnecessary investigations and influencing therapeutic decisions in these individuals.

Keywords

African Ethnicity Neutrophil Race Total leukocyte count 

Notes

Compliance with Ethical Standards

Conflict of interest

None.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No patient/subject identifying information has been disclosed in the manuscript. No patient/subject intervention was done and the subjects were not exposed to any risks during the study.

Informed Consent

Since the study involved a retrospective review of data only from routine testing offered by the laboratory, separate informed consent was not taken for the study. “For this type of study formal consent is not required.”

References

  1. 1.
    Bates I, Lewis SM (2012) Reference ranges and normal values. In: Bain BJ, Bates I, Laffan MA, Lewis SM (eds) Dacie and Lewis Practical Haematology, 11th edn. Elsevier, Amsterdam, pp 11–22CrossRefGoogle Scholar
  2. 2.
    Paz Z, Nails M, Ziv E (2011) The genetics of benign neutropenia. Isr Med Assoc J 13:625–629PubMedGoogle Scholar
  3. 3.
    Haddy TB, Rana SR, Castro O (1999) Benign ethnic neutropenia: what is a normal absolute neutrophil count? J Lab Clin Med 133:15–22CrossRefPubMedGoogle Scholar
  4. 4.
    Zezulka AV, Gill JS, Beevers DG (1987) Neutropenia in black west Indians. Postgrad Med J 63:257–261CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Mason BA, Lessin L, Schechter GP (1979) Marrow granulocyte reserves in black Americans: hydrocortisone-induced granulocytosis in the “benign” neutropenia of the black. Am J Med 67:201–205CrossRefPubMedGoogle Scholar
  6. 6.
    Hsieh MM, Tisdale JF, Rodgers GP, Young NS, Trimble EL, Little RF (2010) Neutrophil count in African Americans: lowering the target cutoff to initiate or resume chemotherapy? J Clin Oncol 28:1633–1637CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Grann VR, Ziv E, Joseph CK, Neugut AI, Wei Y, Jacobson JS et al (2008) Duffy (Fy), DARC, and neutropenia among women from the United States, Europe and the Caribbean. Br J Haematol 143:288–293CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Thobakgale CF, Ndung’u T (2014) Neutrophil counts in persons of African origin. Curr Opin Hematol 21:50–57CrossRefPubMedGoogle Scholar
  9. 9.
    D’Angelo G (2009) Ethnic and genetic causes of neutropenia: clinical and therapeutic implications. Lab Hematol 15:25–29CrossRefPubMedGoogle Scholar
  10. 10.
    Reed WW, Diehl LF (1991) Leukopenia, neutropenia, and reduced hemoglobin levels in healthy American blacks. Arch Intern Med 151:501–505CrossRefPubMedGoogle Scholar
  11. 11.
    Freedman DS, Gates L, Flanders WD, Van Assendelft OW, Barboriak JJ, Joesoef MR et al (1997) Black/white differences in leukocyte subpopulations in men. Int J Epidemiol 26:757–764CrossRefPubMedGoogle Scholar
  12. 12.
    Hsieh MM, Everhart JE, Byrd-Holt DD, Tisdale JF, Rodgers GP (2007) Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences. Ann Intern Med 146:486–492CrossRefPubMedGoogle Scholar
  13. 13.
    Grann VR, Bowman N, Joseph C, Wei Y, Horwitz MS, Jacobson JS et al (2008) Neutropenia in 6 ethnic groups from the Caribbean and the U.S. Cancer 113:854–860CrossRefPubMedGoogle Scholar
  14. 14.
    Bain BJ (1996) Ethnic and sex differences in the total and differential white cell count and platelet count. J Clin Pathol 49:664–666CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Shaper AG, Lewis P (1971) Genetic neutropenia in people of African origin. Lancet 2:1021–1023CrossRefPubMedGoogle Scholar
  16. 16.
    Bain B, Seed M, Godsland I (1984) Normal values for peripheral blood white cell counts in women of four different ethnic origins. J Clin Pathol 37:188–193CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Mantzaris I, Yu Y, Msaouel P, Lam AP, Janakiram M, Friedman EW et al (2016) Analysis of overall survival in a large multiethnic cohort reveals absolute neutrophil count of 1100 as a novel prognostic cutoff in African Americans. Oncotarget 7:67948–67955CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Indian Society of Haematology & Transfusion Medicine 2017

Authors and Affiliations

  • Ritesh Goswami
    • 1
  • Naveen Kakkar
    • 2
  • M. Joseph John
    • 1
  1. 1.Department of Clinical Haematology, Hemato-oncology and Bone Marrow (Stem Cell) TransplantationChristian Medical College & HospitalLudhianaIndia
  2. 2.Department of PathologyChristian Medical College & HospitalLudhianaIndia

Personalised recommendations