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


Journal of Blood Disorders & Transfusion

Author(s): Ibez L, Sabat M, Ballarn E, Puig R, Vidal X, , Ibez L, Sabat M, Ballarn E, Puig R, Vidal X,

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Abstract PURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Copyright 2008 John Wiley & Sons, Ltd. This article was published in Pharmacoepidemiol Drug Saf and referenced in Journal of Blood Disorders & Transfusion

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