Prognostic factors of hematological recovery in life-threatening nonchemotherapy drug-induced agranulocytosis. A study of 91 patients from a single center.
OBJECTIVE
We studied clinical factors that may influence the duration of hematological recovery to reach neutrophil counts and thus, indirectly, the prognosis in patients with life-threatening drug-induced agranulocytosis (DIA).


METHODS
Using univariate and multivariate analyses with Cox's proportional hazard models, we determined the prognostic factors for hematological recovery, defined as neutrophil counts>0.5 and>1.5.10(9)/L, in 91 patients with established life-threatening DIA.


RESULTS
Multivariable analysis showed that neutrophil count<0.1.10(9)/L (at diagnosis) and infection profile: severe infections or septic shock, adversely influenced the neutrophil recovery (for the two neutrophil levels). Hematopoietic growth factors were significantly associated with rapid hematological recovery (for the two neutrophil levels). Documented microbial infections and antiplatelet DIA were also associated with rapid hematological recovery (for a neutrophil count>1.5.10(9)/L).


CONCLUSIONS
Our findings demonstrate that in life-threatening DIA, hematological recovery is mainly dependent of the neutrophil level, the type of infections and the utilization of hematopoietic growth factors.
Maloisel
Fréderic
F
Department of Hematology - Oncology, Hôpitaux universitaires de Strasbourg, France. frédéric.maloisel@chru-strasbourg.edu
Andrès
Emmanuel
E
Kaltenbach
Georges
G
Noel
Esther
E
Martin-Hunyadi
Catherine
C
Dufour
Patrick
P
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000380:Agranulocytosis / Q000139:chemically induced* / Q000473:pathology*; D005260:Female; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils; D011379:Prognosis; D012189:Retrospective Studies
D016298:Hematopoietic Cell Growth Factors