G-CSF plasma levels in clozapine-induced neutropenia
Background: Clinical reports emphasize the therapeutic usefulness of granulocyte colony-stimulating factor (G-CSF) in clozapine-induced granulocytopenia. Only sparse information exists, however, on the natural course of endogenous G-CSF plasma levels in this condition. Methods: We monitored G-CSF an...
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| Main Authors: | , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
27 November 2000
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| In: |
Biological psychiatry
Year: 2000, Volume: 48, Issue: 11, Pages: 1113-1115 |
| ISSN: | 1873-2402 |
| DOI: | 10.1016/S0006-3223(00)00963-X |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/S0006-3223(00)00963-X Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S000632230000963X 
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| Author Notes: | Marek Jauss, Johannes Pantel, Egon Werle, Johannes Schröder |
| Summary: | Background: Clinical reports emphasize the therapeutic usefulness of granulocyte colony-stimulating factor (G-CSF) in clozapine-induced granulocytopenia. Only sparse information exists, however, on the natural course of endogenous G-CSF plasma levels in this condition. Methods: We monitored G-CSF and white blood cell (WBC) counts in a 73-year-old patient who developed granulocytopenia while being treated with clozapine for schizoaffective disorder. Clozapine treatment was discontinued immediately, and G-CSF serum levels were determined repeatedly during the clinical course. Results: Whereas WBC counts increased again within 6 days after discontinuation of clozapine, G-CSF level decreased significantly within the same period. The rapid decrease of endogenous G-CSF levels paralleled by a normalization of neutrophil count was interpreted as the result of an intact regulatory mechanism of granulocytopoesis. Therefore G-CSF therapy was not initiated. Owing to lack of therapeutic alternatives, it was decided to reintroduce clozapine. G-CSF levels decreased further, accompanied by an increase of WBCs, indicating stable bone marrow functioning. Conclusions: Based on this observation, we assume that the course of G-CSF and WBC counts indicated an abortive form of toxic bone marrow damage with subsequent recovery. We conclude that monitoring of G-CSF levels may serve as a useful tool in the follow-up of patients in whom clozapine-induced bone marrow damage is suspected. |
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| Item Description: | Gesehen am 01.02.2021 |
| Physical Description: | Online Resource |
| ISSN: | 1873-2402 |
| DOI: | 10.1016/S0006-3223(00)00963-X |