老年患者非化疗药物所致粒细胞缺乏症：粒细胞集落刺激因子的作用

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

作者信息

Andrès Emmanuel, Kurtz Jean Emmanuel, Martin-Hunyadi Catherine, Kaltenbach Georges, Alt Martine, Weber Jean Christophe, Sibilia Jean, Schlienger Jean Louis, Dufour Patrick, Maloisel F rédéric

机构信息

Department of Internal Medicine, Hôpitaux Universitaires of Strasbourg, Strasbourg, France.

出版信息

Am J Med. 2002 Apr 15;112(6):460-4. doi: 10.1016/s0002-9343(02)01064-1.

DOI:10.1016/s0002-9343(02)01064-1

PMID:11959056

Abstract

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 > or =65 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 a 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 days, 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.

摘要

目的

非化疗药物所致粒细胞缺乏症的老年患者通常伴有严重感染，死亡率至少为20%。我们研究了粒细胞集落刺激因子（G-CSF），一种可缩短中性粒细胞减少持续时间的造血生长因子，对这些患者是否有用。

对象与方法

我们研究了54例年龄≥65岁的药物性粒细胞缺乏症患者，其中部分患者接受了G-CSF治疗。我们确定了血液学恢复（定义为中性粒细胞计数>1.5×10⁹/L）的时间、对G-CSF的耐受性以及临床结局。

结果

54例患者中，20例接受了G-CSF治疗。2例未接受G-CSF治疗的患者死于难以控制的感染性休克和广泛肺炎。接受G-CSF治疗的患者血液学恢复的平均（±标准差）时间显著缩短（6.6±3.9天对8.8±4.9天，P<0.04）。G-CSF治疗的依从性良好；12例患者仅报告有轻微的流感样症状和短暂的骨痛。