TY - JOUR AU - Saettini, Francesco AU - Bonanomi, Sonia AU - Orlandi, Simona AU - Biondi, Andrea AU - Balduzzi, Adriana AU - Coliva, Tiziana PY - 2022/12/21 Y2 - 2024/03/29 TI - Isolated leukopenia in children and adolescents referred to a Pediatric Hematology Clinic JF - Journal of Pediatric and Neonatal Individualized Medicine (JPNIM) JA - J Pediatr Neonat Individual Med VL - 12 IS - 1 SE - DO - 10.7363/120108 UR - https://jpnim.com/index.php/jpnim/article/view/e120108 SP - e120108 AB - <p class="p1"><span class="s1"><strong>Aim:</strong> Pediatric isolated leukopenia (IL) includes multiple conditions but data to guide evaluation of children and adolescents are scarce. The aim of this study was to investigate the underlying diagnoses of IL in a cohort of children and adolescents referred to our Clinic.<span class="Apple-converted-space"> </span></span></p><p class="p1"><span class="s1"><strong>Methods:</strong> Retrospective analysis of 134 consecutive patients with IL, evaluated and followed-up in a Pediatric Hematology Outpatient Clinic. First-level investigations included complete blood count (CBC) with differential, mean corpuscular volume (MCV), and fetal hemoglobin.<span class="Apple-converted-space"> </span></span></p><p class="p1"><span class="s1"><strong>Results:</strong> IL resolved in 50 subjects (37.3%). Seventy-two children (53.7%) were classified as having idiopathic leukopenia. Resolution was less likely if patients presented with more than 1 abnormality at first-level hematological investigations at the time of referral. Molecular analyses identified potential disease-causing variants in 6.7% of the patients. Autoimmune disorders (</span><span class="s2">AID)</span><span class="s1"> and clinical primary immunodeficiencies (c</span><span class="s2">PID)</span><span class="s1"> were common (10.4% and 9.7%, respectively). Five patients (3.7%) ultimately developed a myelodysplastic syndrome (MDS). Patients with monocytopenia and increased MCV had higher risk of developing MDS (p = 0.0002 and p = 0.0001, respectively).<span class="Apple-converted-space"> </span></span></p><p class="p1"><span class="s1"><strong>Conclusions:</strong> In case of recent infection without monocytopenia, increased MCV or multiple CBC abnormalities, post-infectious IL is frequent and white blood cells (WBC) fully recover. A consistent number of patients had underlying AID or cPID. Whenever leukopenia persists beyond 12 months, molecular analyses should be performed and a clonal hematopoietic disorder should be excluded.<span class="Apple-converted-space"> </span></span></p> ER -