Department of Internal Medicine, B Clinic, University Hospital of Strasbourg, Strasbourg, France.
Br J Haematol. 2010 Jul;150(1):3-8. doi: 10.1111/j.1365-2141.2010.08104.x. Epub 2010 Feb 11.
Drug-induced agranulocytosis (neutrophil count <0.5 x 10(9)/l) is a rare haematological complication with an incidence of no more than 10 cases per million inhabitants per year in Europe. Over the past few years there has been a steady decline in mortality rate, (currently at <5%), which can be partly explained by earlier recognition and the improved clinical management of associated intercurrent infections that may lead to severe sepsis if left untreated. The true impact of the use of haematopoietic growth factors, such as granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF), on the decreased mortality rate remains unknown. Yet, most studies show that these molecules, especially G-CSF, reduce the duration of agranulocytosis, antibiotic course and length of hospital stay. Their use is particularly recommended in patients with poor prognostic factors, such as a neutrophil count <0.1 x 10(9)/l, age over 65 years, severe infection or multiple co-morbidities. In all cases, the drug responsible for causing the agranulocytosis must be discontinued and remain permanently contraindicated. The appropriate Medicines Regulatory Agency must also be notified of the adverse event.
药物诱导的粒细胞缺乏症（中性粒细胞计数 <0.5 x 10(9)/l）是一种罕见的血液学并发症，在欧洲每年每百万居民中发生率不超过 10 例。在过去几年中，死亡率稳步下降（目前<5%），这在一定程度上可以解释为更早地认识到并改善了相关并发感染的临床管理，如果不治疗，这些感染可能导致严重败血症。造血生长因子（如粒细胞集落刺激因子[G-CSF]和粒细胞-巨噬细胞集落刺激因子[GM-CSF]）的使用对降低死亡率的真正影响尚不清楚。然而，大多数研究表明，这些分子，特别是 G-CSF，可缩短粒细胞缺乏症的持续时间、抗生素疗程和住院时间。对于预后不良的患者，特别是中性粒细胞计数<0.1 x 10(9)/l、年龄>65 岁、严重感染或多种合并症的患者，特别推荐使用这些药物。在所有情况下，都必须停用导致粒细胞缺乏症的药物，并永久禁忌使用。还必须向适当的药品监管机构报告不良事件。
