This educational program aims to improve awareness and understanding of Duffy null associated neutrophil count (DANC), a common and under-recognized source of health inequality worldwide. Through patient case studies, it will explain how to distinguish DANC from pathological neutropenia, and guide learners through its genetic basis and possible mechanisms. The program will also review the challenges that people with DANC may encounter, and how to mitigate them.

Target Audience

This activity is intended for hematologists, trainees, primary care providers, and healthcare practitioners involved in hematology and those interested in understanding the nuances of neutrophil count and Duffy status.

Learning Objectives

At the end of this educational series, learners should be able to: 

1. Define the Duffy null phenotype and DANC
2. Describe the epidemiology of the Duffy null genotype and phenotype
3. Explain the genetic basis and most likely mechanisms that lead to DANC
4. Differentiate DANC from pathological causes of neutropenia
5. Explain DANC to patients in non-clinical language 
6. Recall evidence-based ANC thresholds for neutropenia in people with the Duffy null phenotype

Learning Format

This course will be delivered in four parts:

• Module 1: Using clinical scenarios, learners will become familiar with how to differentiate Duffy null Associated Neutrophil Count (DANC) from the pathological causes of neutropenia. This module also introduces learners to the biological basis and epidemiology of DANC, and how it can impact healthcare and health inequalities.
• Mini Game: In this educational game, learners test their knowledge of identifying the likely causes of low ANC by evaluating a group of 6 patients. By progressively ordering tests and asking questions, learners will ultimately propose a cause for each patient’s low ANC and what clinical management is required. This activity is suitable as a knowledge and skills refresher after completing the Understanding Duffy Status and Neutrophil Count course or as a way to evaluate baseline knowledge prior to beginning the course.
• Mini Cases: In this set of three case studies, learners will evaluate patients presenting with low ANC and determine whether they represent a clinical emergency, an urgent referral or a routine outpatient workup based on symptoms, laboratory results and history.
• Module 2: This continuing education activity is designed to change competence through increasing a provider’s ability in the identification of Duffy-status through dispelling myths about Duffy-status, providing additional information about Duffy ANC status, and leading learners through an interactive, simulated differential diagnosis activity about other causes of neutropenia.