G-CSF plasma levels in clozapine-induced neutropenia

• Verfasst von: Jauß, Jan Marek [VerfasserIn]
• Verfasst von: Pantel, Johannes [VerfasserIn]
• Verfasst von: Werle, Egon [VerfasserIn]
• Verfasst von: Schröder, Johannes [VerfasserIn]
• Titel: G-CSF plasma levels in clozapine-induced neutropenia
• Verf.angabe: Marek Jauss, Johannes Pantel, Egon Werle, Johannes Schröder
• E-Jahr: 2000
• Jahr: 27 November 2000
• Umfang: 3 S.
• Fussnoten: Gesehen am 01.02.2021
• Titel Quelle: Enthalten in: Biological psychiatry
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1985
• Jahr Quelle: 2000
• Band/Heft Quelle: 48(2000), 11, Seite 1113-1115
• ISSN Quelle: 1873-2402
• DOI: doi:10.1016/S0006-3223(00)00963-X
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Clozapine
• Sach-SW: granulocyte colony-stimulating factor
• Sach-SW: granulocytopenia
• Sach-SW: neutropenia
• K10plus-PPN: 1746340517

Abstract

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.