Schizophrenia research · 2026
Baseline neutrophil count, benign ethnic neutropenia risk, and clozapine haematological monitoring: A multi-ethnic retrospective cohort study from the United Arab Emirates.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bokhari Syed Ali, Elnoor Muhanad, Sabri Mohamed, Bardi Mohammed, Nawaz Faisal A, Javaid Syed Fahad
Аннотация
BACKGROUND: Concerns about haematological toxicity and absolute neutrophil count (ANC) monitoring may limit clozapine use, particularly in multi-ethnic populations where benign ethnic neutropenia (BEN) and lower baseline ANC are common. We characterised baseline ANC distribution, nationality-derived BEN-risk, post-initiation ANC outcomes, and haematological monitoring patterns in a multi-ethnic United Arab Emirates clozapine cohort.
METHODS: We conducted a retrospective cohort study at a tertiary psychiatric hospital in the United Arab Emirates. Adults with documented clozapine administration and at least one post-initiation ANC between 1 January 2018 and 31 July 2024 were included. Nationality-derived BEN-risk, baseline ANC, post-initiation ANC outcomes within a five-band hierarchy, monitoring intensity, and pre-specified sensitivity and exploratory analyses were examined.
RESULTS: Among 239 patients, 179 formed the final study cohort, contributing 284.7 on-clozapine person-years. Overall, 158 patients (88.3%) had no post-initiation ANC <2.0 × 109/L, 16 (8.9%) entered the 1.5-2.0 × 109/L low-ANC monitoring range, 2 (1.1%) reached conventional-threshold neutropenia, 3 (1.7%) reached severe neutropenia, and none reached agranulocytosis range. Five patients (2.8%) met the clinically meaningful ANC <1.5 × 109/L threshold; all were BEN-risk, all had concomitant valproate exposure, and four had concomitant lithium exposure. Baseline ANC was lower in BEN-risk patients and statistically accounted for much of the BEN-risk-to-outcome association in an exploratory analysis.
CONCLUSIONS: Low ANC during clozapine treatment was uncommon and strongly shaped by baseline ANC and BEN-risk context. Baseline ANC-informed and BEN-aware interpretation may reduce unnecessary treatment interruption while preserving haematological safety. BEN-risk was inferred from nationality, not confirmed genetically; all five low-ANC cases received concomitant valproate; associations are observational.
METHODS: We conducted a retrospective cohort study at a tertiary psychiatric hospital in the United Arab Emirates. Adults with documented clozapine administration and at least one post-initiation ANC between 1 January 2018 and 31 July 2024 were included. Nationality-derived BEN-risk, baseline ANC, post-initiation ANC outcomes within a five-band hierarchy, monitoring intensity, and pre-specified sensitivity and exploratory analyses were examined.
RESULTS: Among 239 patients, 179 formed the final study cohort, contributing 284.7 on-clozapine person-years. Overall, 158 patients (88.3%) had no post-initiation ANC <2.0 × 109/L, 16 (8.9%) entered the 1.5-2.0 × 109/L low-ANC monitoring range, 2 (1.1%) reached conventional-threshold neutropenia, 3 (1.7%) reached severe neutropenia, and none reached agranulocytosis range. Five patients (2.8%) met the clinically meaningful ANC <1.5 × 109/L threshold; all were BEN-risk, all had concomitant valproate exposure, and four had concomitant lithium exposure. Baseline ANC was lower in BEN-risk patients and statistically accounted for much of the BEN-risk-to-outcome association in an exploratory analysis.
CONCLUSIONS: Low ANC during clozapine treatment was uncommon and strongly shaped by baseline ANC and BEN-risk context. Baseline ANC-informed and BEN-aware interpretation may reduce unnecessary treatment interruption while preserving haematological safety. BEN-risk was inferred from nationality, not confirmed genetically; all five low-ANC cases received concomitant valproate; associations are observational.