Table 6.
Recent studies on the use of hematopoietic growth factors in idiosyncratic chemical drug-induced agranulocytosis [1,2,3,61,63].
| Type of Study and Target Population | Main Results |
|---|---|
| Systematic review of all published cases (n = 492); All patients with idiosyncratic drug-induced agranulocytosis (Andersohn F. et al. Ann. Intern. Med. 2007, 146, 657–665) | Treatment with hematopoietic growth factors was associated with a statistically significantly lower rate of infectious and fatal complications, in cases with a neutrophil count <0.1 × 109/L. |
| Meta-analysis (n = 118); All patients with idiosyncratic drug-induced agranulocytosis (Ibáñez L. et al. Drug Saf. 2008, 17, 108–109) | G-CSF or GM-CSF (100 to 600 µg/day) reduced the mean time to neutrophil recovery (neutrophil count >0.5 × 109/L) from 10 to 7.7 days, in cases with a neutrophil count <0.1 × 109/L, and reduced the mortality rate from 16 to 4.2%. |
| Case control study, retrospective analysis (n = 70); All patients with idiosyncratic drug-induced agranulocytosis (Sprikkelman A. et al. Leukemia 1994, 8, 2031–2036). | G-CSF and GM-CSF (100 to 600 µg/day) reduced the recovery of neutrophil count from 7 to 4 days, particularly in patients with a neutrophil count <0.1 × 109/L. |
| Cohort study, retrospective analysis (n = 54); Patients with idiosyncratic drug-induced agranulocytosis >65 years of age, with poor prognostic factors (Andrès E. et al. Am. J. Med. 2002, 112, 460–464) | G-CSF (300 µg/day) significantly reduced the mean duration for hematological recovery from 8.8 to 6.6 days (p < 0.04). G-CSF reduced the global cost. |
| Cohort study, retrospective analysis (n = 20); Patients with antithyroid drug-induced agranulocytosis and poor prognostic factors (Andrès E. et al. QJM 2001, 94, 423–428) | G-CSF (300 µg/day) significantly reduced the mean durations of hematological recovery, antibiotic therapy and hospitalization from: 11.6 to 6.8 days, 12 to 7.5 days and 13 to 7.3 days, respectively (p < 0.05 in all cases). G-CSF reduced the global cost. |
| Cohort study, retrospective analysis (n = 145); All patients with idiosyncratic drug-induced agranulocytosis (Ibáñez L. et al. Pharmacoepidemiol. Drug Saf. 2008, 17, 108–109) | G-CSF shortens time to recovery in patients with agranulocytosis. |
| Cohort study, retrospective analysis (n = 201); All patients with idiosyncratic drug-induced agranulocytosis (Andrès E. et al. QJM 2017, 110, 299–305) | G-CSF (300 µg/day) reduced the mean durations of hematological recovery for 2.1 days (p = 0.057). |
| Prospective randomized study (n = 24); All patients with antithyroid drug-induced agranulocytosis (Fukata S. et al. Thyroid 1999, 9, 29–31) | G-CSF (100 to 200 µg/day) did not significantly reduce the mean duration for hematological recovery. |
G-CSF: Granulocyte-colony stimulating factor. GM-CSF: Granulocyte-macrophage-colony stimulating factor.