Protocolo diagnóstico y terapéutico de la neutropenia

Abstract

Neutropenia consists of a decrease in the absolute neutrophil count. It is a common and potentially serious complication in patients with hematologic and oncologic diseases. Its origin may be linked to underlying diseases, myelosuppressive chemotherapy, or hematopoietic stem cell transplantation. It greatly increases the risk of serious bacterial and fungal infections. Effective management of neutropenia is crucial in order to prevent infectious complications and improve clinical outcomes. It can have various causes, including autoimmune disorders, nutritional deficiencies, viral infections, infectious pathogens, and myelosuppressive drugs. The diagnosis is based on assessing the absolute neutrophil count and classifying it according to severity. Infections can be ruled out by means of a detailed clinical history and, in certain situations, by performing imaging tests. The possibility of underlying hematologic disorders should be assessed through specific tests, such as a bone marrow biopsy, flow cytometry, and next-generation sequencing. Managing neutropenia entails the identification and treatment of the underlying cause as well as the prevention and management of infectious complications. Treatment measures range from suspending myelosuppressive drugs to using colony-stimulating factors, empirical antibiotic therapy in cases of febrile neutropenia, and antifungal prophylaxis in high-risk patients. Multidisciplinary care is required for comprehensive, optimal management of neutropenia.