Granulocyte colony stimulating factor (G-CSF) can allow treatment with clozapine in a patient with severe benign ethnic neutropaenia (BEN): a case report

Benjamin W J Spencer, Hugh R J Williams, Siobhan H Gee, Eromona Whiskey, Joseph P Rodrigues, Aleksandar Mijovic, James H MacCabe

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19 Citations (Scopus)
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Abstract

Clozapine is the treatment of choice for treatment-resistant schizophrenia, but it is associated with a risk of neutropaenia and agranulocytosis. Clozapine use is regulated by mandatory blood monitoring in the UK, requiring cessation of treatment should the absolute neutrophil count (ANC) drop below specified values. Benign reductions in the ANC in non-white populations are common, and this can preclude a patient from receiving treatment with clozapine. A diagnosis of benign ethnic neutropaenia can reduce these treatment restrictions (UK specific), but the degree of neutropaenia can be significant enough to still prevent treatment. In this report, we show that response to granulocyte colony stimulating factor (G-CSF) may be quite variable and difficult to predict, but with careful monitoring it can be used to increase the ANC count and allow continued treatment with clozapine.
Original languageEnglish
Pages (from-to)1280-1282
Number of pages3
JournalJournal of Psychopharmacology
Volume26
Issue number9
DOIs
Publication statusPublished - Sept 2012

Keywords

  • Severity of Illness Index
  • Young Adult
  • Drug Interactions
  • Immunologic Factors
  • Recombinant Proteins
  • Humans
  • Drug Resistance
  • Antipsychotic Agents
  • Great Britain
  • Leukocyte Count
  • Schizophrenia
  • Neutropenia
  • Granulocyte Colony-Stimulating Factor
  • Neutrophils
  • Adult
  • Clozapine
  • Drug Monitoring
  • Treatment Outcome
  • African Continental Ancestry Group
  • Male

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