Independent associations of lymphopenia and neutropenia in patients with systemic lupus erythematosus: A longitudinal, multinational study

Rangi Kandane-Rathnayake, Worawit Louthrenoo, Vera Golder, Shue Fen Luo, Yeong Jian J. Wu, Aisha Lateef, Jiacai Cho, Zhanguo Li, Yuan An, Laniyati Hamijoyo, Sandra Navarra, Leonid Zamora, Yasuhiro Katsumata, Masayoshi Harigai, Sargunan Sockalingam, Madelynn Chan, Yi Hsing Chen, Sean O'neill, Fiona Goldblatt, Yanjie HaoZhuoli Zhang, Jun Kikuchi, Tsutomu Takeuchi, Chak Sing Lau, Mandana Nikpour, Eric Morand, Alberta Hoi

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Objective. The prevalence and associations of leucopenia in SLE remain incompletely understood. We evaluated associations of disease activity and medication use with leucopenia (lymphopenia and neutropenia) in a multinational, prospectively followed SLE cohort. Methods. Data from the Asia Pacific Lupus Collaboration cohort, in which disease activity and medications were prospectively captured from 2013 to 2018, were used. Predictors of lymphopenia (lymphocyte count <0.8×109/l) and neutropenia (neutrophil count <1.5×109/l) were examined using multiple failure, time-dependent survival analyses. Results. Data from 2330 patients and 18 287 visits were analysed. One thousand and eighteen patients (43.7%) had at least one episode of leucopenia; 867 patients (37.2%) had lymphopenia, observed in 3065 (16.8%) visits, and 292 (12.5%) patients had neutropenia, in 622 (3.4%) visits. After multivariable analyses, lymphopenia was associated with overall disease activity, ESR, serology, prednisolone, AZA, MTX, tacrolimus, CYC and rituximab use. MTX and ciclosporin were negatively associated with neutropenia. Lupus low disease activity state was negatively associated with both lymphopenia and neutropenia. Conclusion. Both lymphopenia and neutropenia were common in SLE patients but were differentially associated with disease and treatment variables. Lymphopenia and neutropenia should be considered independently in studies in SLE.

Original languageEnglish
Pages (from-to)5185-5193
Number of pages9
JournalRheumatology (United Kingdom)
Issue number11
Publication statusPublished - 2021 Nov 1


  • SLE disease activity
  • leucopenia
  • lymphopenia
  • medications
  • neutropenia

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)


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