The application of hematopoietic growth factors in drug-induced agranulocytosis: a review of 70 cases.
Since 1989, granulocyte-macrophage and granulocyte colony-stimulating factors (GM-CSF, G-CSF) have been increasingly applied in the treatment of drug-induced agranulocytosis. In order to evaluate the effectiveness of GM-CSF and G-CSF in the treatment of drug-induced agranulocytosis, we have studied all reported cases (n = 70) treated with GM-CSF and G-CSF, including ten patients treated during the last 2 years in The Netherlands. The results demonstrate that patients with a severe granulocytopenia (< 0.1 x 10(9)/l) treated with hematopoietic growth factors had a significantly faster recovery of the peripheral blood granulocytes compared to previous published studies. At the same time, a significantly lower mortality rate was observed. In patients with a severe granulocytopenia treated with GM-CSF or G-CSF a mortality rate of 5% was noted. No difference in granulocyte recovery was observed in patients treated with GM-CSF or G-CSF. The results of this review indicate that G-CSF and GM-CSF enhance the recovery of the myeloid lineage, resulting in a faster normalization of the peripheral blood granulocyte count and a reduced incidence of fatal complications.
Sprikkelman
A
A
Department of Hematology, University Hospital, Groningen, The Netherlands.
de Wolf
J T
JT
Vellenga
E
E
D000380:Agranulocytosis / Q000097:blood / Q000139:chemically induced / Q000628:therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006098:Granulocytes; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count
D016298:Hematopoietic Cell Growth Factors; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor