Nonchemotherapy drug-induced agranulocytosis in elderly patients:: The effects of granulocyte colony-stimulating factor

PURPOSE. Elderly patients with nonchemotherapy drug-induced agranulocytosis present commonly with severe infections and have a mortality of at Least 20%. We studied whether granulocyte colony-stimulating factor (G-CSF), a hematopoietic growth factor that shortens the duration of neutropenia, is useful in these patients. SUBJECTS AND METHODS: We studied 54 patients greater than or equal to65 years of age who had drug-induced agranulocytosis some of whom had been treated with G-CSF. We determined the times until hematologic recovery (defined as 2 neutrophil count >1.5 X 10(9)/L), tolerance of G-CSF, and clinical outcomes. RESULTS: Of the 54 patients, 20 received G-CSF. Two patients who had not been treated with G-CSF died of uncontrolled septic shock and extensive pneumonia. The mean (+/- SD) time until hematologic recovery was significantly less in patients treated with G-CSF (6.6 +/- 3-9 days vs. 8-8 +/- 4-9.dals, P < 0.04). Compliance with G-CSF therapy was good, only mild flu-like symptoms and transient bone pain were reported in 12 patients. CONCLUSION: Our findings suggest that G-CSF therapy may be beneficial in the management of drug-induced agranulocytosis in elderly patients. (C) 2002 by Excerpta Medica, Inc.