Latest news with #neutropenia
Medscape
14-07-2025
- Health
- Medscape
EU to Ease Clozapine Monitoring Frequency After First Year
The European Medicines Agency's (EMA) Pharmacovigilance Risk Assessment Committee has recommended easing routine blood count monitoring for patients on clozapine, citing new data that show that the risk for severe neutropenia and agranulocytosis declines significantly after the first year of treatment. Under the updated guidelines, monitoring for patients without a history of neutropenia can be reduced to once every 12 weeks after the first year, and to once annually after 2 years. In addition, absolute neutrophil count (ANC) will now be the sole parameter used for hematologic monitoring, replacing the previous requirement to also measure white blood cell count. The revised recommendations are supported by a joint expert statement from the European Clozapine Task Force, published this year, which called for changes to the monitoring protocol due to the very low incidence of late-onset agranulocytosis. Additional evidence comes from a large-scale study involving more than 26,000 patients, which found that clozapine-induced severe neutropenia peaked around week 9 (0.128% weekly incidence) and declined sharply after week 18, with rates becoming negligible — 0.001% per week — after 2 years of continuous use. Mechanism and Risk Profile Clozapine is an atypical antipsychotic indicated for treatment-resistant schizophrenia and for patients who cannot tolerate other antipsychotics due to neurologic side effects. It is also used to manage psychosis associated with Parkinson's disease when standard treatments fail. Clozapine works by antagonizing dopamine D2 and serotonin 5-HT2A receptors, contributing to its unique efficacy in refractory schizophrenia. However, it carries a known risk for drug-induced neutropenia and its most severe form, agranulocytosis. Research suggests that a reactive metabolite of clozapine, the nitrenium ion, may bind to neutrophil proteins. This complex is then thought to act as a hapten, triggering an immune response that leads to the destruction of neutrophils, a process for which certain individuals may have a genetic predisposition. All clozapine-containing products in the European Union will be updated to reflect the new ANC-based monitoring schedule and thresholds for treatment initiation and continuation. The direct healthcare professional communication will be distributed by the marketing authorization holders in coordination with national authorities, and published on EMA and national regulatory websites. Clinicians are encouraged to review and update monitoring protocols accordingly and continue reporting suspected adverse events through established pharmacovigilance channels.
BBC News
07-05-2025
- Health
- BBC News
Stem cell donors: Five-year-old Arsenal fan needs to find match
'You wouldn't know to look at him that he's ill' 9 minutes ago Share Save Share Save DKMS Mason needs to find a stem cell donor Mason is like most five-year-old boys, according to his mother Emily. He loves dance, gymnastics, doing arts and crafts, being on his scooter, supporting Arsenal, playing dress-up and baking. But Mason, who lives in Islington, north London, needs to find a potentially life-saving 10/10 matching stem cell donor to treat his severe congenital neutropenia, a rare blood disorder. "I just want him to have a normal life – this has always been his normal, but all the hospital visits, surgeries, tests, cannulations and injections shouldn't be his normal," says Emily. 'Magic medicine' Mason's condition means he is at risk from life-threatening bacterial infections and an increased risk of leukaemia and other cancers. The stem cell transplant will replace damaged or diseased bone marrow with healthy stem cells, which will then create new blood cells, reduce his symptoms and lessen the risk of leukaemia developing. His dual Caribbean (Bajan/St Lucian) and British heritage means finding a matching donor is an even greater challenge. None of his family are a match. People from UK ethnic minority heritages are under-represented on the stem cell donor register, and people from such backgrounds often face a much longer wait to find a matching donor. Mason is one of approximately 2,000 people in the UK who are waiting for a stem cell transplant. Emily says: "Mason knows that he needs 'magic medicine' and that it will come from someone else. "He's very resilient and just gets on with it – even though he's been through so much and I wouldn't be able to cope with half of what he has gone through. "But we've talked to him about sharing his story, to help him and other people find a match, and he's said yes, he wants to help." "To look at him right now, you wouldn't know he is ill and needs a transplant," she added. On Sunday Mason's family and friends, led by Emily, held a stem cell donor registration event to encourage more people to sign up as potential stem cell donors. The process is described as "quick and easy, and can be completed with a simple cheek swab". DKMS Mason is one of about 2,000 people in the UK waiting for a stem cell transplant Blood cancer charity DKMS helped organise the donor registration event at a primary school in Islington. The charity's spokesperson, Deborah Hyde, says: "By registering as a donor, you could give hope not just to Mason, but countless others from all backgrounds, who are relying on the stem cell register for a second chance at life. "Signing up is a quick and easy process involving some painless mouth swabs: if you are aged 17 to 55 and in general good health, you're eligible to join the register with DKMS. "And if you were then matched with someone needing a transplant, in nine out of ten cases donating is a simple, outpatient process similar to donating blood platelets." Listen to the best of BBC Radio London on Sounds and follow BBC London on Facebook, X and Instagram. Send your story ideas to
