DRUG-INDUCED AGRANULOCYTOSIS

Sixty-two cases of drug-induced agranulocytosis, spontaneously reporte d to the regional drug monitoring centre in Lyon from 1988 to 1994, ha ve been analysed. The mean age of patients was 58.6 years, and sex rat io was 1:1. The mean delay of onset was 46.2 days and absolute neutrop hil counts (ANC) dropped below 0.1 x 10(9)/l in 73 per cent of patient s. Bone marrow aspirates disclosed absence of myeloid series in 28 per cent of investigated cases. Neutrophil recovery occurred after a mean of 9.3 days, and the overall fatality rate was 6.5 per cent. Haematop oietic growth factors (HGF) were used in 11 patients with an ANC below 0.1 x 10(9)/l and/or a hypoplastic bone marrow. We have found no clea r indication for a potential benefit of HGF treatment, but HGF were us ually administered late during the course of neutropenia, i.e. after a mean of 6 days. The incidence rate estimated for people living in the Rhone administrative division was 3.3 per million per year, similar t o that found in epidemiological studies. Drugs most frequently involve d were anti-infective agents and psychotropic drugs.