Can a Benign Hematology Phenomenon Critically Impact the Neutropenia Status and Treatment of Patients With Cancer?

Neutropenia in oncology care usually has a disease-related or therapy-related etiology. However, for a population with a benign hematology phenomenon known as benign ethnic neutropenia (BEN) or Duffy-null associated neutrophil count (DANC), neutropenia can be unexpected or more severe during oncology care. A lack of awareness of this phenomenon and its impact can lead to actions that result in treatment delays, dose reductions, or even treatment discontinuation. Additionally, patients may be excluded from clinical trials, and neutropenia may be inaccurately graded as an adverse event or used incorrectly as a criterion for remission status due to the reference range for neutrophil counts often based on values for individuals without BEN/DANC. The population with BEN/DANC also overlaps with historically underserved groups in health care, further highlighting the urgency of raising awareness about the effects of BEN/DANC in cancer care. This presentation emphasizes the critical impact BEN/DANC plays in the neutropenia status in some oncology patients and proposes a new algorithm that advanced practitioners (APs) can use to identify BEN/DANC during initial cancer evaluation for optimization of time-sensitive and dose-sensitive therapies.