Björkholm M, Pisa P, Arver S, Beran M
Division of Medicine, Karolinska Institute and Hospital, Stockholm, Sweden.
J Intern Med. 1992 Nov;232(5):443-5. doi: 10.1111/j.1365-2796.1992.tb00612.x.
A 61-year-old female patient, treated for hyperthyroidism with thiamazole, developed a severe maturation arrest in the granulocytic lineage and a total agranulocytosis. Subcutaneous GM-CSF was started immediately and given for 6 days. Bone marrow samples were taken before GM-CSF therapy and on days 3 and 8. An increased number of colonies per 10(5) bone marrow cells documented before institution of GM-CSF treatment was followed by a gradual decline to normal values. An increase of granulocyte count to > 0.5 x 10(9) l-1 was recorded on the 4th day of treatment and was preceded by an increase in the number of immature granulocyte precursors in the bone marrow on day 3. The patient was discharged on day 8 and experienced no adverse effects of GM-CSF treatment. Haematopoietic growth factor therapy has a place in the management of patients with drug induced neutropenia/agranulocytosis, which should be further delineated by prospective studies.
一名61岁女性患者，因使用甲巯咪唑治疗甲状腺功能亢进，出现严重的粒细胞系成熟停滞和全血细胞减少症。立即开始皮下注射粒细胞巨噬细胞集落刺激因子（GM-CSF），持续给药6天。在GM-CSF治疗前以及治疗第3天和第8天采集骨髓样本。在GM-CSF治疗开始前，每10⁵个骨髓细胞的集落数量增加，随后逐渐下降至正常值。治疗第4天记录到粒细胞计数增加至>0.5×10⁹/L⁻¹，在此之前第3天骨髓中未成熟粒细胞前体数量增加。患者于第8天出院，未出现GM-CSF治疗的不良反应。造血生长因子疗法在药物性中性粒细胞减少症/全血细胞减少症患者的管理中具有一席之地，前瞻性研究应进一步明确这一点。
