Non-malignant neutropenia

Neutropenia occurs when the production of neutrophils by the bone marrow is outpaced by utilization in the periphery. Abnormalities of hematopoietic stem-cell development and decreased proliferation of neutrophil precursors in the marrow can reduce production of neutrophils. Conversely, decreased neutrophil survival in the peripheral circulation can also give rise to neutropenia. Non-malignant neutropenia of acute onset can be caused by infection, antibody-mediated destruction, or an idiosyncratic reaction to a drug. Severe chronic neutropenia is a global, descriptive term for several disorders of varied etiologies in which neutrophil levels are consistently or recurrently at levels less than 0.5 x 10(9)/L. Despite this heterogeneity of origin, administration of recombinant human granulocyte colony stimulating factor to individuals with severe chronic neutropenia results in an increase in neutrophil counts in most patients associated with a significantly improved quality of life.