Treatment of clozapine-induced agranulocytosis with recombinant granulocyte colony-stimulating factor.

BACKGROUND

Is clozapine-induced agranulocytosis amenable to treatment with recombinant granulocyte colony-stimulating factor (rG-CSF)? Will this treatment provide benefits in terms of morbidity, mortality, and costs compared with current treatment?

METHOD

Five patients with clozapine-induced agranulocytosis (granulocytes < 500/cu mm) were treated with the rG-CSF filgrastim, in addition to standard agranulocytosis therapy protocol.

RESULTS

Time from onset until resolution of agranulocytosis was 8.2 +/- 2.1 days compared with a historical study of seven cases where filgrastim was not used and 15.7 +/- 3.7 days were required for resolution.

CONCLUSION

rG-CSF (filgrastim) may be an effective and cost-reducing way to provide improved treatment for clozapine-induced agranulocytosis. More research is required.