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Andrès E, Maloisel F, Kurtz JE, et al. Modern management of non-chemotherapy drug-induced agranulocytosis: a monocentric cohort study of 90 cases and review of the literature. Eur J Intern Med. 2002;13(5):324-328doi: 10.1016/s0953-6205(02)00085-7.
Andrès, E., Maloisel, F., Kurtz, J. E., Kaltenbach, G., Alt, M., Weber, J. C., Sibilia, J., Schlienger, J. L., Blicklé, J. F., Brogard, J. M., & Dufour, P. (2002). Modern management of non-chemotherapy drug-induced agranulocytosis: a monocentric cohort study of 90 cases and review of the literature. European journal of internal medicine, 13(5), 324-328. https://doi.org/10.1016/s0953-6205(02)00085-7
Andrès, Emmanuel, et al. "Modern management of non-chemotherapy drug-induced agranulocytosis: a monocentric cohort study of 90 cases and review of the literature." European journal of internal medicine vol. 13,5 (2002): 324-328. doi: https://doi.org/10.1016/s0953-6205(02)00085-7
Andrès E, Maloisel F, Kurtz JE, Kaltenbach G, Alt M, Weber JC, Sibilia J, Schlienger JL, Blicklé JF, Brogard JM, Dufour P. Modern management of non-chemotherapy drug-induced agranulocytosis: a monocentric cohort study of 90 cases and review of the literature. Eur J Intern Med. 2002 Aug;13(5):324-328. doi: 10.1016/s0953-6205(02)00085-7. PMID: 12144912.
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Eur J Intern Med. 2002 Aug;13(5):324-328. doi: 10.1016/s0953-6205(02)00085-7.

Modern management of non-chemotherapy drug-induced agranulocytosis: a monocentric cohort study of 90 cases and review of the literature.

European journal of internal medicine

Emmanuel Andrès, Frédéric Maloisel, Jean Emmanuel Kurtz, Georges Kaltenbach, Martine Alt, Jean Christophe Weber, Jean Sibilia, Jean Louis Schlienger, Jean Frédéric Blicklé, Jean Marie Brogard, Patrick Dufour

Affiliations

  1. Department of Internal Medicine, Service de Médecine Interne, Clinique Médicale B, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67 091 Cedex, Strasbourg, France

PMID: 12144912 DOI: 10.1016/s0953-6205(02)00085-7

Abstract

BACKGROUND: The present study reports a monocentric experience of 90 drug-induced agranulocytosis cases and discusses their management, in particular the role of hematopoietic growth factors. METHODS: Data from 90 patients with drug-induced agranulocytosis who met the criteria of the IAAAS group and of Bénichou and Solal-Celigny [Nouv Rev Fr Hematol 1993; 33: 257.] were retrospectively reviewed. All cases were extracted from a cohort study of the Hopitaux Universitaires de Strasbourg, France. Data were specifically analyzed with regard to the use of hematopoietic growth factors (in 42 patients). RESULTS: Mean patient age was 63 (range 17-95) years and the sex ratio (M/F) was 0.39. An underlying disease was present in 37% of the patients. Antibiotics (25%), antithyroid drugs (23%), and antiaggregative platelet agents (16%) were the most frequent causative drugs. Main clinical features included isolated fever (41%), septicemia or septic shock (31%), and pneumonia (10%). Mean neutrophil count was 0.13 (range 0-0.46)x10(9)/l. Outcome was favorable in 98% of patients. The mean durations of hematological recovery (neutrophil count over 1.5x10(9)/l), antibiotic therapy, and hospitalization was 8.5 (range 2-21) days, 9.2 (range 2-21) days, and 10.5 (range 3-23) days, respectively. All patients were treated with broad-spectrum antibiotics and 42 patients with hematopoietic growth factors. In these 42 patients, the mean durations for hematological recovery, antibiotic therapy, and hospitalization were significantly reduced at: 6.3 (range 2-16) days, 7.1 (range 2-16) days, and 9.1 (range 3-23) days, respectively (all P<0.05). CONCLUSIONS: The present study shows that new causative drugs are emerging (antibiotics, antithyroid, and antiaggregative platelet agents), that drug-induced agranulocytosis remains typically a serious accident with severe sepsis, and that modern management with broad spectrum antibiotics and hematopoietic growth factors may reduce the mortality.

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