Severe chronic neutropenia: Treatment and follow-up of patients in the Severe Chronic Neutropenia International Registry
| Autor: | Laurence A. Boxer, Mary Ann Bonilla, David C. Dale, Bonnie Cham, Audrey Anna Bolyard, Sally E. Kinsey, Melvin H. Freedman, Cornelia Zeidler, Karl Welte, George Kannourakis, Robert L. Davis, Beate Schwinzer, Carol Fier, Debra Scarlata, Tammy Cottle |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Internationality Neutropenia Adolescent medicine.medical_treatment Splenectomy Growth Filgrastim Glomerulonephritis Pregnancy hemic and lymphatic diseases Internal medicine Granulocyte Colony-Stimulating Factor Humans Medicine Registries Child Adverse effect Congenital Neutropenia Aged Aged 80 and over business.industry Infant Hypertrophy Hematology Middle Aged medicine.disease Surgery Cell Transformation Neoplastic Treatment Outcome Child Preschool Chronic Disease Osteoporosis Female business Vasculitis Kostmann syndrome Follow-Up Studies medicine.drug |
| Zdroj: | American Journal of Hematology. 72:82-93 |
| ISSN: | 1096-8652 0361-8609 |
| Popis: | Severe chronic neutropenia (SCN) is defined as an absolute neutrophil (ANC) of less than 0.5 x 10(9)/L, lasting for months or years. Congenital, cyclic, and idiopathic neutropenia are principal categories of SCN. Since 1994, the Severe Chronic Neutropenia International Registry (SCNIR) has collected data to monitor the clinical course, treatments, and disease outcomes for SCN patients. This report summarizes data for 853 patients, almost all treated with daily or alternate-day recombinant human granulocyte colony-stimulating factor (G-CSF or Filgrastim). G-CSF treatment increased the ANC overall from 0.34 x 10(9)/L +/- 0.018 pre-treatment to 3.70 x 10(9)/L +/- 0.18 during the first year of treatment. For most patients, the responses were durable with patients remaining on the same dose of G-CSF for many years. Long-term hematological observations showed stable mean leukocyte and neutrophil counts and gradually increasing hemoglobin levels. Thrombocytopenia developed in 4% of patients. As of January 1, 2000, myelodysplasia (MDS) or acute myelogenous leukemia (AML) has occurred in 35 of 387 patients with congenital neutropenia with a cumulative risk of 13% after 8 years of G-CSF treatment. This event occurred without a predictable relationship to the duration or dose of G-CSF treatment. No patients with cyclic or idiopathic neutropenia developed MDS or AML. Other important adverse events included hepatomegaly, osteoporosis, vasculitis, glomerulonephritis, and deaths in 4 of 14 cases requiring splenectomy. Growth and development and the outcome of pregnancy appeared to be unaffected by G-CSF treatment. These data indicate that congenital, cyclic, and idiopathic neutropenia can be effectively treated with long-term G-CSF. The risk of leukemia, osteoporosis, other potentially adverse events, and pregnancy outcome need to be further evaluated with continuing long-term observations. |
| Databáze: | OpenAIRE |
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