Granulocyte colony-stimulating factor plasma levels during clozapine- and olanzapine-induced granulocytopenia.
OBJECTIVE
Recent case studies suggest that impaired granulopoiesis, well-known to occur during clozapine treatment, may also be observed when olanzapine is administered. The underlying mechanisms are unknown, but haematopoietic cytokines such as granulocyte colony-stimulating factor (G-CSF) are likely to be involved.


METHODS
We measured the plasma levels of G-CSF and of other cytokines longitudinally in a female patient who developed granulocytopenia twice, first during clozapine treatment and again when olanzapine was administered.


RESULTS
G-CSF levels, but not those of other cytokines, closely paralleled granulocyte counts, yielding a significant positive correlation. G-CSF was not detectable in plasma when granulocytopenia occurred. Granulocytopenia resolved spontaneously despite continuing treatment with olanzapine.


CONCLUSIONS
The present case suggests that clozapine and olanzapine both are able to induce transient granulocytopenia through a similar or common mechanism that does not involve a compensatory increase in G-CSF levels.
Max Planck Institute of Psychiatry, München, Germany.
A
A
Schuld
T
T
Kraus
D
D
Hinze-Selch
M
M
Haack
T
T
Pollmächer
D000328:Adult; D000380:Agranulocytosis / Q000097:blood* / Q000139:chemically induced*; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines; D003024:Clozapine / Q000009:adverse effects* / Q000627:therapeutic use; D016207:Cytokines / Q000097:blood; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006098:Granulocytes / Q000166:cytology; D006760:Hospitalization; D006801:Humans; D007958:Leukocyte Count; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012075:Remission, Spontaneous; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy*
D014150:Antipsychotic Agents; D016207:Cytokines; D001569:Benzodiazepines; D016179:Granulocyte Colony-Stimulating Factor; D010890:Pirenzepine; D003024:Clozapine; D000077152:Olanzapine