Incidence, etiology and bone marrow characteristics of non‐chemotherapy‐induced agranulocytosis

Figures & data

Figure 1. Type I agranulocytosis revealed prominent promyelocytes and metamyelocytes but rare mature forms (×1000).

Figure 2. Type II agranulocytosis showed rare granulocytic precursors (×1000).

Table 1. Incidences of agranulocytosis during 1993–2007

Year	Total admission	Case	Incidence (case/10 000 admissions/year)
1993	19 097	2	1·05
1994	19 710	3	1·52
1995	21 749	3	1·38
1996	22 886	5	2·18
1997	25 101	5	1·99
1998	26 570	6	2·26
1999	28 718	0	0
2000	30 393	2	0·66
2001	32 044	3	0·94
2002	30 536	1	0·33
2003	29 093	1	0·34
2004	31 857	2	0·63
2005	33 436	0	0
2006	34 956	4	1·14
2007	34 934	1	0·29

Table 2. Drugs associated with agranulocytosis in 38 cases

Drugs	Frequency
Antimicrobial agents
Trimethoprim‐sulfamethoxazole	7
Ceftazidime	6
Cloxacillin	5
Clindamycin	2
Gentamycin	2
Other cephalosporins	4
Chloramphenicol	1
Rifampicin	1
PGS	1
Acyclovir	1
Antithyroid agents
Methimazole	4
Propylthiouracil	2
Others
Diclofenac	2
Phenytoin	2
Allopurinol	1
Ticlopidine	1
Unknown	2

Table 3. Comparison between two types of bone marrow and clinical characteristics

Variables	Type I	Type II	P value
Age (mean±SD), (years)	32·7±16	44·3±9·2	0·09
Duration of exposed drug (mean±SD), (days)	25·2±23	17·1±13·2	0·41
WBC median (IQR), (×10^9/l)	1·2 (1·05–1·5)	0·5 (0·35–0·95)	0·03
ANC median (IQR), (×10^9/l)	0 (0–0·04)	0 (0–0)	0·31
Platelets (mean±SD), (×10^9/l)	243·8±102·3	176·3±182·2	0·31
Hb median (IQR), (g/dl)	10 (7–11)	10 (7·5–11·5)	0·80
Duration of neutropenia (mean±SD), (days)	13·1±8·9	10·4±5·7	0·91
Mortality rate (%)	0	42·9	0·04

Note: SD, standard deviation; WBC, white blood cell count; IQR, interquartile range; ANC, absolute neutrophil count; Hb, hemoglobin.

The P values in bold indicate statistical significance.