What Is Cyclic Neutropenia?

Cyclic neutropenia is a rare form of neutropenia, or blood disorder, which usually appears in intervals of two weeks to a month. Each period of incidence lasts three to six days. Cyclic neutropenia is also known as cyclical neutropenia or cyclic hematopoiesis.

In general, neutropenia is a medical condition that occurs when the number of neutrophils is abnormally low. Neutrophils are the body’s most important group of white blood cells, or leukocytes, because they are the cells of the immune system that combat infectious diseases. Neutrophils, which comprise up to 75 percent of leukocytes, perform this duty by destroying bacteria in the blood. Thus, the reduced amount of neutrophils leads to a deficiency of the immune system’s primary defense, and causes a person to be more susceptible to bacterial infections and diseases in general.

Cyclic neutropenia could be triggered by low bone marrow production, which can be traced to a hereditary disorder. This concerns the mutation of neutrophil elastase, usually abbreviated as ELA2 and also known as leukocyte elastase. This is an enzyme that contributes to the destruction of bacteria. In general, however, neutropenia has several possible causes. These include damaged or reduced bone narrow due to other conditions such as cancer or a production deficiency called aplastic anemia; destruction of neutrophils by certain pharmaceuticals or autoimmune disorders; and viral infections such as human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS).

People with cyclic neutropenia usually discover it by accident at a routine medical check-up. Others discover it after experiencing a serious infection with symptoms such as diarrhea, mouth ulcers, sore throat or burning sensation during urination. Cyclic neutropenia is considered a rare form of the disorder and is usually benign. Some people, however, have lost their lives as a result of the infection because they are made more vulnerable by it.

Since cyclic neutropenia is typically inherited, it can be detected in multiple members of the same family. Physicians determine the extent of the condition by breaking it down into three categories based on an absolute neutrophil count (ANC). These consist of mild neutropenia, which denotes minimal risk of bacterial infection; moderate neutropenia, which represents moderate risk; and severe neutropenia, which represents a serious risk. Although no ideal treatment for cyclic neutropenia exists, doctors traditionally rely on granulocyte colony-stimulating factor (G-CSF or GCSF) hormones such as Filgrastim to combat it.