A widespread misunderstanding in medical practice is causing undue stress and potentially harmful interventions for many Black patients. The issue stems from the interpretation of white blood cell counts, which are often lower in people of African or Middle Eastern descent due to a genetic variant. Vanessa Apea’s experience exemplifies this problem. As a 21-year-old medical student, she was told her low white blood cell count could indicate leukemia, causing significant distress. It took a second opinion from a Black doctor to reveal that her results were perfectly normal for someone of her ancestry.
This phenomenon, historically termed “benign ethnic neutropenia,” affects nearly 67% of Black patients. It’s caused by a genetic variant that allows certain white blood cells to migrate more easily into tissues, resulting in lower blood counts without increased infection risk. The problem stems from medicine’s reliance on norms based primarily on white male physiology. This bias leads to the pathologizing of healthy individuals and can result in unnecessary procedures, delayed treatments, and exclusion from clinical trials.
Dr. Lauren Merz, a hematology/oncology fellow at Dana-Farber Cancer Institute, is advocating for change. She proposes renaming the condition to “Duffy-null associated neutrophil count” to avoid racial stigmatization and urges hospitals to adopt diverse reference norms for blood tests. The impact of this misunderstanding extends beyond individual anxiety. It can affect treatment options, with some Black patients being denied certain medications or given lower doses due to their “low” white blood cell counts. It may also contribute to lower participation rates of Black individuals in clinical trials.
As medicine grapples with embedded racial biases, addressing this issue represents a crucial step towards more equitable healthcare for all patients, regardless of their racial or ethnic background.
See “She was told she might have cancer: How medicine pathologizes Black patients’ normal test results” (September 9, 2024)
