A Roadmap for Developing and Implementing Duffy Null-Specific Reference Intervals
The Duffy null variant is found in 10% of the United States population, and results in distinct absolute neutrophil counts (ANC) and white blood cell count (WBC) RIs. Investigators from twenty-three institutions completed a collaborative assessment of ANC and WBC in healthy Duffy-null pediatric and adult participants. This report summarizes a roadmap for developing and implementing Duffy-null RIs and infrastructure. Through consensus, we identified the following key themes: 1) Identifying Stakeholders and Funding, 2) Collecting Samples, 3) Testing for Duffy Status, 4) Implementing Duffy-Specific Policies and Tools, and 5) Educating Providers and Duffy-null individuals. Across themes, we outline challenges and opportunities relevant to the development and implementation of Duffy-null infrastructure. We provide examples from community and academic practice settings as well as sites with geographic, size, funding, and population diversity. This roadmap will support healthcare systems, hospitals, and laboratories in developing and implementing Duffy-specific infrastructure.
Authors
- Alexa J. Siddon (ORCID: https://orcid.org/0000-0002-2372-3653)
- Vivian Y. Chang (ORCID: https://orcid.org/0000-0002-4538-1500)
- Lauren E. Merz (ORCID: https://orcid.org/0000-0002-6618-803X)
- Zhen W. Mei (ORCID: https://orcid.org/0000-0002-3810-2673)
- Abraham Haimed (ORCID: https://orcid.org/0009-0002-1353-766X)
- Warren Benjamin Fingrut (ORCID: https://orcid.org/0000-0002-5017-1583)
- Maureen Achebe (ORCID: https://orcid.org/0000-0002-1514-2357)
- Lucy A. Godley (ORCID: https://orcid.org/0000-0003-1914-9158)
- Samuel Wilson (ORCID: https://orcid.org/0000-0001-6517-0076)
- Chibuzo Ilonze (ORCID: https://orcid.org/0000-0002-6852-2644)
- Amy C. Soni (ORCID: https://orcid.org/0009-0000-3403-5381)
Institutions
- Northwestern University (US)
- University of North Carolina at Chapel Hill (US)
- Brigham and Women's Hospital (US)
- Children's Hospital of Philadelphia (US)
- The University of Texas MD Anderson Cancer Center (US)
- Harvard University (US)
- University of California, Los Angeles (US)
- University of Alabama (US)
- University of Michigan (US)
- University of Alabama at Birmingham (US)
- Yale University (US)
- Levine Cancer Institute (US)
Publication Details
- Journal
- Blood Advances
- Published
- 2026-11-05
- DOI
- https://doi.org/10.1182/bloodadvances.2026021681
- Primary Topic
- Clinical Laboratory Practices and Quality Control
- Type
- article
- Field-Weighted Citation Impact
- 0.00