Acute and chronic neutropenias. What is new?

Recently, some of the mechanisms and consequences in the severe chronic neu tropenias (e.g. the neutrophil elastase gene mutations and the risk to prog ress to myelodysplasia and acute leukaemia) and in drug-induced agranulocyt osis (e.g. the apoptosis-inducing ability of metabolites of clozapine) have been elucidated, and new aspects of autoimmune and the large granular lymp hocyte syndrome were described (e.g. aberrant elaboration of Fas-ligand cau sing neutrophil apoptosis). Investigations of the mild to moderate chronic neutropenias have shown the significance of interactions between the myeloi d development and the immune network (e.g. relations to immunoglobulin aber rations). Granulocyte-colony stimulation factor (G-CSF) is Widely used in p atients with severe chronic neutropenia, however, its use in other conditio ns is mostly based on anecdotal evidence. In addition, immune modulating re gimens, such as metothrexate, ciclosporine and monoclonal antibodies, are i ncreasingly employed for the autoimmune neutropenias.