What is your approach to management of chronic neutropenia in a patient with Sjogren’s who was recently diagnosed with metastatic endometrial cancer and plans to start chemotherapy?

With metastatic cancer, optimal treatment of the endometrial cancer is the priority. Heme/Onc consultant would likely be giving granulocyte stimulating products.

Although neutropenia can occur in Sjogren's Disease (SjD), I rarely have found it to be clinically significant, and lymphopenia seems to occur far more often. That said, I have seen a number of pts with neutropenia during the COVID-era. The Greece Sjogren's group is looking at the Harmonics Sjogren's data set to understand the leukopenia/neutropenia phenotype, but no data yet (Stergiou et al., PMID 35611111).

In SjD, a few potential medications may be associated with neutropenia, such as sulfasalazine, and rituximab (late-onset effect).

In SjD, there is an association of HPV with cerv...