Hummer M, Kurz M, Barnas C, Saria A, Fleischhacker W W
Department of Psychiatry, Innsbruck University Clinics, Austria.
J Clin Psychiatry. 1994 Oct;55(10):429-32.
The aim of the study was to shed more light on the incidence and course of clozapine-induced transient white blood count (WBC) disorders.
In an analysis of our clozapine drug monitoring program, we evaluated the data of 68 patients receiving clozapine for the first time. Incidence rates were calculated by actuarial life table analysis. The potential influence of sex, age, dose, and plasma level was evaluated using discriminant analysis.
Two patients developed progressive neutropenia, leading to agranulocytosis in one case. We also found the following transient hematologic dysfunctions: neutropenia (22.0%), eosinophilia (61.7%), and leukocytosis (40.9%). One patient showed chronic leukocytosis. Additionally, minor changes in the number of lymphocytes, monocytes, and basophilic granulocytes were detected in the study population.
Hematologic side effects are frequently induced by the atypical antipsychotic clozapine. Next to agranulocytosis, a progressive and potentially lethal hematologic adverse effect, most of the WBC disorders are transient and appear to be harmless.
本研究旨在更深入地了解氯氮平所致短暂性白细胞计数（WBC）紊乱的发生率及病程。
在对我们的氯氮平药物监测项目进行分析时，我们评估了68例首次接受氯氮平治疗患者的数据。通过精算生命表分析计算发生率。使用判别分析评估性别、年龄、剂量和血浆水平的潜在影响。
2例患者出现进行性中性粒细胞减少，其中1例导致粒细胞缺乏症。我们还发现了以下短暂性血液学功能障碍：中性粒细胞减少（22.0%）、嗜酸性粒细胞增多（61.7%）和白细胞增多（40.9%）。1例患者表现为慢性白细胞增多。此外，在研究人群中检测到淋巴细胞、单核细胞和嗜碱性粒细胞数量的轻微变化。
非典型抗精神病药物氯氮平常引起血液学副作用。除了粒细胞缺乏症这种进行性且可能致命的血液学不良反应外，大多数白细胞紊乱是短暂的，似乎无害。
