Merck Manual

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Overview of Leukopenias


Mary Territo

, MD, David Geffen School of Medicine at UCLA

Last full review/revision Jan 2020| Content last modified Jan 2020
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Leukopenia is a reduction in the circulating white blood cell (WBC) count to < 4000/mcL (< 4 × 109/L). It is usually characterized by a reduced number of circulating neutrophils, although a reduced number of lymphocytes, monocytes, eosinophils, or basophils may also contribute. Thus, immune function can be generally decreased.

Neutropenia is a reduction in blood neutrophil count to < 1500/mcL (< 1.5 × 109/L) in whites and < 1200/mcL (< 1.2 × 109/L) in blacks. It is sometimes accompanied by monocytopenia and lymphocytopenia, which cause additional immune deficits.

Lymphocytopenia, in which the total number of lymphocytes is < 1000/mcL (< 1 × 109/L) in adults, is not always recognized as a decrease in the total WBC count because lymphocytes account for only 20 to 40% of the total WBC count. The consequences of the lymphopenia can depend on the lymphocyte subpopulation(s) that are decreased.

Monocytopenia is a reduction in blood monocyte count to < 500/mcL (< 0.5 × 109/L). Monocytes migrate into the tissues where they become macrophages, with specific characteristics depending on their tissue localization.

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