Which of the following best represents the risk factors for agranulocytosis?

Which of the following best represents the risk factors for agranulocytosis?

• A. Younger age, male gender
• B. Ashkenazi Jews only
• C. Older age, female gender, Ashkenazi Jews
• D. Older age only

Answer: (C)

Agranulocytosis risk with certain antipsychotics, especially clozapine, is shaped by both how the drug can affect the bone marrow and who the patient is. Older age means reduced bone-marrow reserve, so neutrophil counts can drop more easily. Female patients tend to have higher susceptibility to some immune-related adverse drug reactions, including agranulocytosis. Ethnicity can reflect genetic factors that influence drug metabolism or immune reactions; in this context, Ashkenazi Jewish heritage has been associated with a higher risk in some populations treated with clozapine. When these factors are present together—older age, female gender, and Ashkenazi Jewish ethnicity—the risk is greatest, which is why this combination is identified as the best representation of risk factors. This also explains the need for closer hematologic monitoring (regular neutrophil counts) in patients with this profile.

Agranulocytosis risk with certain antipsychotics, especially clozapine, is shaped by both how the drug can affect the bone marrow and who the patient is. Older age means reduced bone-marrow reserve, so neutrophil counts can drop more easily. Female patients tend to have higher susceptibility to some immune-related adverse drug reactions, including agranulocytosis. Ethnicity can reflect genetic factors that influence drug metabolism or immune reactions; in this context, Ashkenazi Jewish heritage has been associated with a higher risk in some populations treated with clozapine. When these factors are present together—older age, female gender, and Ashkenazi Jewish ethnicity—the risk is greatest, which is why this combination is identified as the best representation of risk factors. This also explains the need for closer hematologic monitoring (regular neutrophil counts) in patients with this profile.