# ASH publishes first reference ranges of white blood cell counts for Duffy-null children and adults

- Published: 2026-11-05 22:05 UTC
- Section: Life & Health › Medicine
- Tags: Duffy-null status, white blood cell count reference range, absolute neutrophil count, benign ethnic neutropenia, Duffy antigen, pediatric reference intervals, American Society of Hematology, Blood Advances, neutropenia misdiagnosis
- URL: https://realtech.media/news/rt-820cb5441615f0524edf3ac2_ash_publishes_first/

**Based on 1,412 samples from 23 U.S. sites, the ranges cover adults and four pediatric age groups and are meant to reduce false flags of neutropenia.**

![ASH publishes first reference ranges of white blood cell counts for Duffy-null children and adults](https://sgzwpqqelzmajkcubgkl.supabase.co/storage/v1/object/public/rt-media/2026/11/c70590851a08cd6e.jpg)
*Ajay Kumar Chaurasiya, Wikimedia Commons, CC BY-SA 4.0*

The American Society of Hematology (ASH) has published reference ranges for white blood cell and neutrophil counts in children and adults with Duffy-null status, news-medical.net reports. The ranges appeared in Blood Advances and are described as the first of their kind. Duffy-null status is a common genetic trait associated with naturally lower circulating white blood cell counts; according to ASH, it affects more than 66% of people with African or Mediterranean ancestry in the US. [1]

Researchers at 23 U.S. sites collected 1,412 samples from Duffy-null individuals. The samples were used to validate adult ranges and to collect the first data for pediatric ranges. The authors reported no meaningful differences in the ranges across sites once differences in collection strategies and patient populations were accounted for. [1]

## Why standard ranges can mislead

The Duffy antigen is a protein on red blood cells; in Duffy-null individuals it is naturally absent. Its absence protects against infection with malaria parasites. It also affects the distribution of neutrophils: more of them are concentrated in tissues and fewer circulate in the blood, from which samples for laboratory tests are drawn. [1]

As a result, total white blood cell and neutrophil counts in Duffy-null people are lower than in Duffy-positive people. Under standard ranges this can be flagged as neutropenia, which may lead to bone marrow biopsies, exclusion from clinical trials or discontinuation of therapies such as chemotherapy. ASH stresses that Duffy-null status is not a disease but a genetic variant. [1]

## The new ranges

The values are given for absolute neutrophil count (ANC) and white blood cell count (WBC), in ×10⁹/L. Adults: ANC 1.03–7.30, WBC 3.0–10.7. Children 6 months to 2 years: ANC 0.53–4.50, WBC 4.4–12.6. Children 3 to 6 years: ANC 0.78–4.67, WBC 3.8–10.8. [1]

Children 7 to 12 years: ANC 0.87–5.34, WBC 2.9–10.1. Children 13 to 17 years: ANC 0.90–4.89, WBC 3.1–9.2. Reference intervals for children under 6 months old still require further research. [1]

Study author Maureen Achebe of Brigham and Women's Hospital and Dana-Farber Cancer Institute said the ranges are a concrete, implementable step toward recognizing what is normal for Duffy-null individuals. The work is part of ASH's ANC by Duffy Status Project. As part of the same initiative, ASH also published a study in Blood Advances reporting that universal pediatric testing for the Duffy-null variant is cost effective. [1]

## Sources

1. [news-medical.net](https://www.news-medical.net/news/20261105/ASH-establishes-new-blood-reference-ranges-for-Duffy-null-individuals.aspx)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-820cb5441615f0524edf3ac2_ash_publishes_first/