Use of granulocyte colony-stimulating factor (G-CSF) and outcome in patients with non-chemotherapy agranulocytosis

Pharmacoepidemiology and Drug Safety
Luisa IbáñezAgranulocytosis and Aplastic Anaemia Study Group of Barcelona

Abstract

The use of granulocyte colony-stimulating factor (G-CSF) in the treatment of non-chemotherapy drug- induced agranulocytosis is controversial. We aimed at assessing the effect of G-CSF on the duration of agranulocytosis. To assess the effect of G-CSF on the duration of agranulocytosis, a Cox proportional hazard model with an estimated propensity score covariate adjusting for several prognostic factors was used. One hundred and forty-five episodes of agranulocytosis were prospectively collected from January 1994 to December 2000 in Barcelona (Spain). No differences were found in the case-fatality rate between treated (9 of 101, 8.9%) and not treated (5 of 44, 11.4%) patients. The median time to reach a neutrophil count > or =1.0 x 10(9)/L was 5 days (95%CI 5-6) in patients treated with G-CSF compared to 7 days (95%CI 6-8) in those not treated, with a hazard ratio of 1.58 (95% CI 1.1-2.3). G-CSF shortens time to recovery in patients with agranulocytosis. However, as an effect on case-fatality has not been recorded, and data on cost-effectiveness are lacking, it would be wise to restrict its use to high-risk patients.

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Citations

May 27, 2015·Basic & Clinical Pharmacology & Toxicology·Nicolás Medrano-CasiqueElena Ramírez
May 22, 2009·American Journal of Hematology·Daniel TesfaJan Palmblad
Apr 10, 2015·International Journal of Clinical Pharmacy·Neila FathallahChaker Ben Salem
Sep 25, 2014·Journal of Pharmacy Practice·Rickey C Miller, Alison Steinbach
Oct 6, 2018·Fundamental & Clinical Pharmacology·Thierry VialUNKNOWN French Network of Pharmacovigilance Centres
Jun 14, 2020·Journal of Clinical Medicine·Noel Lorenzo-VillalbaEmmanuel Andrès
Sep 8, 2017·Expert Opinion on Drug Safety·Emmanuel Andrès, Rachel Mourot-Cottet
Apr 19, 2011·Expert Review of Hematology·Emmanuel AndrèsFrédéric Maloisel
Nov 21, 2020·The Annals of Pharmacotherapy·Christo CiminoElizabeth J Phillips

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