Benign ethnic neutropenia (BEN) is an important issue in clozapine-treatment. Clozapine is effective in treatment-resistant schizophrenia. Agranulocytosis is a severe adverse effect of clozapine that limits its more widespread use. Total white cell and/or neutrophil counts indicate agranulocytosis. Patients with low counts cannot start or have to discontinue clozapine-treatment. Agranulocytosis due to clozapine occurs in about 1% of patients taking clozapine, neutropenia in about 3% (Rajagopal,2005).

Among many ethnic groups, a significant proportion of people have BEN. Definition of BEN: “When neutropenia, defined by normative data in white populations, occurs in individuals of other ethnic groups who are otherwise healthy and who do not have repeated or severe infections, the condition may be referred to as benign ethnic neutropenia” ((Haddy, 1999: p15).

Benign ethnic neutropenia has been observed a.o. in (Haddy, 1999):

• Africans
• American and British children and adults of African descent
• West Indians in the UK
• Middle Eastern people including:
  • Yemenite Jews
    black Beduin Arabs
    Ethiopian Jews
    Jordanians

More specific data:
The prevalence of benign neutropenia among healthy Arabs was present in 10.7% (healthy indigenous population (n = 1032) from the United Arab Emirates) Denic, 2009.
In the table below: Prevalence of neutropenia and leukopenia according to Shoenfeld, 1988, among Ethiopian Jews (Falashas) (who migrated to Israel) and among the Beduin tribes in the Negev region of Israel (Abu Blal of the Tarabin/Abu Rabiah of the Tiha): These Beduins are composed of two distinct ethnic subgroups: Black beduins (Africans originating from the Sudan (n=47) who have black skin) and Semitic Arabs (n=53) who are light-skinned.

Additional data will follow. Readers should consult the original sources for exact blood cell count-classifications of neutropenia and leukopenia.

Mario Braakman, Editor