Prognostic factors of hematological recovery in life-threatening nonchemotherapy drug-induced agranulocytosis -: A study of 91 patients from a single center

Objectives We studied clinical factors that may influence the duration of hematological recovery to reach neutrophil counts and thus, indirectly, the prognosis in patients with life-threatening drug-induced agranulocytosis (DIA). Methods Using univariate and multivariate analyses with Cox's proportional hazard models, we determined the prognostic factors for hematological recovery defined as neutrophil counts > 05 and > 1.5.10(9)/L, in 91 patients with established life-threatening DIA. Results Multivariable analysis showed that neutrophil count < 0.1.10(9)/L (at diagnosis) and infection profile: severe infections or septic shock, adversely influenced the neutrophil recovery (for the two neutrophil levels). Hematopoietic growth factors were significantly associated with rapid hematological recovery (for the two neutrophil levels). Documented microbial infections and antiplatelet DIA were also associated with rapid hematological recovery (for a neutrophil count > 15.10(9)/L). Conclusion Our findings demonstrate that in life-threatening DIA, hematological recovery is mainly dependant of the neutrophil level, the type of infections and the utilization of hematopoietic growth factors.