THE APPLICATION OF HEMATOPOIETIC GROWTH-FACTORS IN DRUG-INDUCED AGRANULOCYTOSIS - A REVIEW OF 70 CASES

Since 1989, granulocyte-macrophage and granulocyte colony-stimulating factors (GM-CSF, G-CSF) have been increasingly applied in the treatmen t of drug-induced agranulocytosis. In order to evaluate the effectiven ess of GM-CSF and G-CSF in the treatment of drug-induced agranulocytos is, we have studied all reported cases (n = 70) treated with GM-CSF an d G-CSF, including ten patients treated during the last 2 years in The Netherlands. The results demonstrate that patients with a severe gran ulocytopenia (<0.1 x 10(9)/l) treated with hematopoietic growth factor s had a significantly faster recovery of the peripheral blood granuloc ytes compared to previous published studies. At the same time, a signi ficantly lower mortality rate was observed. In patients with a severe granulocytopenia treated with GM-CSF or G-CSF a mortality rate of 5% w as noted. No difference in granulocyte recovery was observed in patien ts treated with GM-CSF or G-CSF. The results of this review indicate t hat G-CSF and GM-CSF enhance the recovery of the myeloid lineage, resu lting in a faster normalization of the peripheral blood granulocyte co unt and a reduced incidence of fatal complications.