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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Endocrinol. | doi: 10.3389/fendo.2019.00789

Granulocyte-Colony-Stimulating Factor Effectively Shortens Recovery Duration in Anti-Thyroid-Drug-Induced Agranulocytosis: A Systematic Review and Meta-Analysis

Yonghui Wang1, Xiaoying Li1, Qian Yang1, Wei Wang1, Yannan Zhang1,  JUN LIU1, Liang Zheng2 and  Bingbing Zha1*
  • 1Shanghai Fifth People's Hospital, Fudan University, China
  • 2Shanghai East Hospital, Tongji University School of Medicine, China

Background and aim: Granulocyte-colony-stimulating factor (G-CSF) is highly beneficial as a general treatment for anti-thyroid drug (ATD)-induced agranulocytosis. This meta-analysis aimed to assess the clinical effects of G-CSF and non-G-CSF on recovery duration in patients with ATD-induced agranulocytosis by analyzing the overall clinical outcomes.
Methods: PubMed, Embase, Ovid, Cochrane, Google Scholar, China National Knowledge Infrastructure (CNKI )databases were searched for published studies from 1900 to 2018. No language restriction was implemented.
Results: This meta-analysis included 10 published retrospective studies and 1 prospective study. Data were obtained from 11 trials (474 patients: 247 with G-CSF and 227 with non-G-CSF treatment). Compared with the non-G-CSF group, the G-CSF group presented shorter recovery duration [weighted mean difference (WMD) = –3.04 days, 95% confidence interval (95% CI): –4.38 to –1.67 (Z = 4.43 P = 0.000)]. However, the recovery duration fluctuated across different regions and recovery criteria. Asian patients achieved significant clinical outcomes [WMD = –3.16 days (95% CI: –4.58 to –1.74, P = 0.000)] compared with European and South American patients [WMD = –2.19 days (95% CI: –7.38 to 3.01, P = 0.409)]. Also, according to various recovery criteria, the duration of granulocyte count increase of more than 1.5 or 1.0 × 109/L [WMD = –3.50 days (95% CI: –4.82 to –2.18, P = 0.000)] revealed better treatment effect.
Conclusion: G-CSF could significantly shorten the recovery duration in patients with ATD-induced agranulocytosis.

Keywords: G-CSF, Hyperthyroidism, Treatment, ATD, Agranulocytosis

Received: 21 Jul 2019; Accepted: 30 Oct 2019.

Copyright: © 2019 Wang, Li, Yang, Wang, Zhang, LIU, Zheng and Zha. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Bingbing Zha, Shanghai Fifth People's Hospital, Fudan University, Shanghai, Beijing Municipality, China,