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Duffy-null Associated Neutrophil Count

Duffy-null Associated Neutrophil Count (DANC)

Reconsidering the Use of Race in Clinical Tools: Duffy-null Associated Neutrophil Count (DANC)

The American Society of Hematology (ASH) will be leading a two-year health equity project focused on ensuring that individuals with Duffy-null associated neutrophil count (DANC) receive appropriate care. Approximately two in three people in the United States who are of African or Middle Eastern ancestry have the Duffy null phenotype, which is defined as the non-expression of the Duffy antigen on red blood cells. Many individuals with the Duffy null phenotype are incorrectly labeled as having neutropenia – a condition that increases the risk of infection or suggests disordered bone marrow function. This mislabeling can result in unnecessary, expensive, and invasive testing, delayed or discontinued chemotherapy, exclusion from clinical trials, restricted access to therapeutics, and other negative consequences. Ensuring proper care of these individuals can be achieved by expanding the collective understanding of Duffy-null-associated neutrophil count (DANC) and its impact on the continuum from clinical trials to proper care. This will be accomplished through three objectives:

  1. Empowering selected health care systems to reconsider their ANC ranges for the Duffy-null population and sharing information about their efforts.
  2. Educating health care professionals about DANC.
  3. Intervening at the population level, including education of clinical trialists and the public about the implications of DANC.

This work is funded by a grant from the Doris Duke Charitable Foundation.

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