Conflict of interest was declared—Initially, the network for the surveillance of blood dyscrasias was part of the International Agranulocytosis and Aplastic Anemia Study (IAAAS), which was carried out between 1980 and 1986 and was funded by Hoechst AG (Frankfurt). From 1987 to 2000 the network did not receive any external financial support, except personnel by the public health provider organisation Institut Català de la Salut and partial funding by the Spanish Medicines Agency (Agencia Española del Medicamento y Productos Sanitarios, AEMPS). Since January 2001, our institute receives partial funding from Institut Català de la Salut, the AEMPS and from Sanofi-Aventis and Boehringer Ingelheim. Data analysis and interpretation, and the preparation of the present manuscript have been independent from all the sponsors.
Use of granulocyte colony-stimulating factor (G-CSF) and outcome in patients with non-chemotherapy agranulocytosis†
Article first published online: 8 JAN 2008
Copyright © 2008 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 17, Issue 3, pages 224–228, March 2008
How to Cite
Ibáñez, L., Sabaté, M., Ballarín, E., Puig, R., Vidal, X. and Laporte, J.-R. (2008), Use of granulocyte colony-stimulating factor (G-CSF) and outcome in patients with non-chemotherapy agranulocytosis. Pharmacoepidem. Drug Safe., 17: 224–228. doi: 10.1002/pds.1542
Julià A (Service of Hematology, Hospital Vall d'Hebron, Barcelona), Brunet S, Ayats R (Service of Hematology, Hospital St Pau, Barcelona), Besses C, Pérez Vila E (Service of Hematology and Laboratory of Cytology Hospital del Mar, Barcelona), Bosch A (LRC SA and Service of Hematology, Hospital de Mataró), Domingo A, Alonso E, de la Banda E (Service of Hematology HPPE Bellvitge), Estella J, Toll T (Service of Hematology Hospital Sant Joan de Déu, Esplugues), García M (Service of Hematology.Laboratory, Hospital de Terrassa), López R (Service of Hematology. Laboratory, Hospital de Granollers), Millà F, Navarro T (Service of Hematology, HUGTIP Badalona), Nomdedeu B, Esteve J (Service of Hematology, Hospital Clínic i Provincial, Barcelona), Olivé T (Service of Hematology, Hospital Infantil Vall d'Hebron Barcelona), Peris J (Service of Hematology. Laboratory, Hospital Municipal, Badalona), Pineda A (Service of Hematology. Laboratory, Hospital de Barcelona), Roig I, Soler A (Service of Hematology. Laboratory, CS Parc Taulí, Sabadell), Soto R, de Diego I (Service of Hematology, Hospital Mútua, Terrassa).
- Issue published online: 25 FEB 2008
- Article first published online: 8 JAN 2008
- Manuscript Accepted: 20 NOV 2007
- Manuscript Received: 9 MAY 2007
- drug-induced agranulocytosis;
- granulocyte colony-stimulating factor;
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 ≥1.0 × 109/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. Copyright © 2008 John Wiley & Sons, Ltd.