Granulocyte colony-stimulating factor (G-CSF) does not improve recovery from antithyroid drug-induced agranulocytosis: A prospective study

Agranulocytosis is the most serious side effect of antithyroid drug (ATD) t herapy. We conducted prospective and randomized studies to examine whether granulocyte colony-stimulating factor (G-CSF) is actually effective for ATD -induced agranulocytosis. Twenty-four patients with Graves' disease who dev eloped agranulocytosis during ATD therapy were randomly divided into a G-CS F group (n = 14) and an untreated group (n = 10). Subcutaneous injection of G-CSF (100 to 250 mu g) was given daily until neutrophil counts rose to gr eater than 1000/mu L. The untreated group received antibiotic therapy only. Recovery time, which is defined as the number of days required for neutrop hil counts to exceed 500/mu L, was monitored by daily complete blood count (CBC). Recovery time in the G-CSF-treated group did not differ from that of the untreated group in those patients with moderate and severe agranulocyt osis; thus, prolonged use of G-CSF treatment is generally ineffective for A TD-induced agranulocytosis.