Characterization of the phenotypic consequences of the Duffy-null genotype

Abstract: A wealth of research focused on African American populations has connected rs2814778-CC (“Duffy-null”) to decreased neutrophil (neutropenia) and leukocyte counts (leukopenia). Although it has been proposed that this variant is benign, prior studies have shown that the misinterpretation of...

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Main Authors: Micah R. Hysong, Megan M. Shuey, Jennifer E. Huffman, Paul Auer, Alexander Reiner, Laura M. Raffield
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952925000370
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author Micah R. Hysong
Megan M. Shuey
Jennifer E. Huffman
Paul Auer
Alexander Reiner
Laura M. Raffield
author_facet Micah R. Hysong
Megan M. Shuey
Jennifer E. Huffman
Paul Auer
Alexander Reiner
Laura M. Raffield
author_sort Micah R. Hysong
collection DOAJ
description Abstract: A wealth of research focused on African American populations has connected rs2814778-CC (“Duffy-null”) to decreased neutrophil (neutropenia) and leukocyte counts (leukopenia). Although it has been proposed that this variant is benign, prior studies have shown that the misinterpretation of Duffy-null–associated neutropenia and leukopenia can lead to unnecessary bone marrow biopsies, inequities in cytotoxic and chemotherapeutic treatment courses, underenrollment in clinical trials, and other disparities. To investigate the phenotypic correlates of Duffy-null status, we conducted a phenome-wide association study across >1400 clinical conditions in All of Us, the Vanderbilt University Medical Center’s Biobank, and the Million Veteran Program. This reveals that Duffy-null status is only reproducibly associated with changes in white blood cell count and not with any disease outcomes. Moreover, we find that Duffy-null–associated neutropenia is on average less severe than other neutropenia cases in All of Us. We also show that this genotype is present in considerable frequencies in All of Us populations that are genetically similar to African (68%) and Middle Eastern (14%) 1000 Genomes/Human Genome Diversity Project reference populations as well as those who identify with >1 race (12%), as Pacific Islander (7%), and as Hispanic (5%). Furthermore, we find that race is not an accurate predictor of Duffy-null status or associated benign neutropenia. Our research suggests that broad genetic screening of rs2814778 across all populations could provide a more robust and accurate understanding of white blood cell count and mitigate resulting health disparities.
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spelling doaj-art-0c14df4fcc0c46e79720159c7b5a14bd2025-08-20T03:02:37ZengElsevierBlood Advances2473-95292025-03-01961452146210.1182/bloodadvances.2024014399Characterization of the phenotypic consequences of the Duffy-null genotypeMicah R. Hysong0Megan M. Shuey1Jennifer E. Huffman2Paul Auer3Alexander Reiner4Laura M. Raffield5Department of Genetics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NCVanderbilt Genetics Institute and Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TNMassachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, MA; Palo Alto Veterans Institute for Research, Palo Alto Health Care System, Palo Alto, CA; Department of Medicine, Harvard Medical School, Boston, MADivision of Biostatistics, Data Science Institute, and Cancer Center, Medical College of Wisconsin, Milwaukee, WIDepartment of Epidemiology, University of Washington, Seattle, WADepartment of Genetics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Correspondence: Laura M. Raffield, Department of Genetics, The University of North Carolina at Chapel Hill, 5042 Genetic Medicine Building, 120 Mason Farm Rd, Chapel Hill, NC 27599;Abstract: A wealth of research focused on African American populations has connected rs2814778-CC (“Duffy-null”) to decreased neutrophil (neutropenia) and leukocyte counts (leukopenia). Although it has been proposed that this variant is benign, prior studies have shown that the misinterpretation of Duffy-null–associated neutropenia and leukopenia can lead to unnecessary bone marrow biopsies, inequities in cytotoxic and chemotherapeutic treatment courses, underenrollment in clinical trials, and other disparities. To investigate the phenotypic correlates of Duffy-null status, we conducted a phenome-wide association study across >1400 clinical conditions in All of Us, the Vanderbilt University Medical Center’s Biobank, and the Million Veteran Program. This reveals that Duffy-null status is only reproducibly associated with changes in white blood cell count and not with any disease outcomes. Moreover, we find that Duffy-null–associated neutropenia is on average less severe than other neutropenia cases in All of Us. We also show that this genotype is present in considerable frequencies in All of Us populations that are genetically similar to African (68%) and Middle Eastern (14%) 1000 Genomes/Human Genome Diversity Project reference populations as well as those who identify with >1 race (12%), as Pacific Islander (7%), and as Hispanic (5%). Furthermore, we find that race is not an accurate predictor of Duffy-null status or associated benign neutropenia. Our research suggests that broad genetic screening of rs2814778 across all populations could provide a more robust and accurate understanding of white blood cell count and mitigate resulting health disparities.http://www.sciencedirect.com/science/article/pii/S2473952925000370
spellingShingle Micah R. Hysong
Megan M. Shuey
Jennifer E. Huffman
Paul Auer
Alexander Reiner
Laura M. Raffield
Characterization of the phenotypic consequences of the Duffy-null genotype
Blood Advances
title Characterization of the phenotypic consequences of the Duffy-null genotype
title_full Characterization of the phenotypic consequences of the Duffy-null genotype
title_fullStr Characterization of the phenotypic consequences of the Duffy-null genotype
title_full_unstemmed Characterization of the phenotypic consequences of the Duffy-null genotype
title_short Characterization of the phenotypic consequences of the Duffy-null genotype
title_sort characterization of the phenotypic consequences of the duffy null genotype
url http://www.sciencedirect.com/science/article/pii/S2473952925000370
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