title: Use of granulocyte colony-stimulating factor (filgrastim) in the treatment of non-cytotoxic drug-induced agranulocytosis.
abstract: Five patients with non-cytotoxic drug-induced agranulocytosis were treated with recombinant human granulocyte-colony-stimulating factor (rh-G-CSF). The drugs involved were dipyrone, captopril, clozapine and carbimazole. Bone marrow examination revealed a depleted granulopoiesis with normal erythro- and megakaryocytopoiesis. After discontinuation of the suspected drug, rh-G-CSF was administered daily at 5 microg/kg subcutaneously. The neutrophil counts were recovered between day 6 and 12 and patients were discharged from hospital shortly afterwards. Compared to data from the literature, the neutrophil recovery appeared to be faster than expected without the use of haematopoietic growth factors. In conclusion, rh-G-CSF at a standard dose of 5 microg/kg seems to be an effective treatment for drug-induced agranulocytosis.
authors.affiliation: First Department of Internal Medicine, University of Cologne, Germany.
authors.forename: P D
authors.initials: PD
authors.lastname: Wickramanayake
authors.forename: C
authors.initials: C
authors.lastname: Scheid
authors.forename: A
authors.initials: A
authors.lastname: Josting
authors.forename: I
authors.initials: I
authors.lastname: Katay
authors.forename: A
authors.initials: A
authors.lastname: Schulz
authors.forename: V
authors.initials: V
authors.lastname: Diehl
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000188:drug therapy* / Q000209:etiology; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011994:Recombinant Proteins
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim