Nonchemotherapy Drug‐Induced Agranulocytosis: A Review of 118 Patients Treated with Colony‐Stimulating Factors

Abstract

To determine the role of growth factors in nonchemotherapy drug-induced agranulocytosis, we reviewed 118 published reports of administration of colony-stimulating factors for the disorder. Main outcomes were total duration of neutropenia and mortality. The mean time to neutrophil recovery was 4.6 +/- 3.2 days and 7.7 +/- 5.1 days in patients with a granulocyte count at diagnosis of 0.1-0.5 x 10(3)/mm3 and less than 0.1 x 103/mm3, respectively. The mortality rate was 4.2%. Without therapy with growth factors, the mean time to neutrophil recovery after discontinuation of the offending agent was reported to be 10 +/- 8 days. The mortality rate was 16% in one study. We conclude that hematopoietic growth factors may shorten the duration of neutropenia and reduce mortality in patients with severe drug-induced agranulocytosis.

Nonchemotherapy drug‐induced agranulocytosis: interest of haematopoietic growth factors

“…More recently, in a multivariate analysis of all our drug-induced agranulocytosis patients (n ¼ 91), we have demonstrated that haematopoietic granocytecolony stimulating factors was an independent variable positively affecting the duration of haematological recovery (manuscript in preparation). These data are consistent with the two recent studies of Sprikkelman et al (n ¼ 70) [6] and Beauchesne (n ¼ 118) [7] (Table 1).…”

“…We have previously demonstrated that the use of granocyte-and granocyte macrophage-colony stimulating factors was safe and led a significant reduction for a mean of ) and reduce the mortality rate from 16 to 4.2% [7] a Time for neutrophils count to be >0. . The duration of antibiotics, hospitalization, as well as the global cost of agranulocytosis management were also reduced.…”

Antithyroid Drug-induced Agranulocytosis Complicated by Pneumococcal Sepsis and Upper Airway Obstruction

“…Meanwhile, G-CSF has been reported to shorten the duration of neutropenia in patients with drug-induced agranulocytosis in other studies (13,14) and to reduce mortality in a meta-analysis of 118 published reports (15). The present findings also support the effectiveness of G-CSF in treating ATD-induced agranulocytosis.…”

Diagnosis and Management of Idiopathic Drug-Induced Severe Neutropenia and Agranulocytosis

“…To our knowledge, no data is available with pegylated G-CSF. The most recent, major studies on haematopoietic growth factors use in drug-induced agranulocytosis are described in table 3 [18][19][20][21][22]. In our aforementioned cohort, a faster haematological non significantly recovery (neutrophil count > 1.5 x 109/L) was observed in the haematopoietic growth factors group: 2.1 days (p=0.057) [8].…”