ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P365 | DOI: 10.1530/endoabs.63.P365

Comparison of G-CSF and non-G-CSF treatment of agranulocytosis in patients with hyperthyroidism: a meta-analysis

Yonghui Wang1, Xiaoying Li1, Qian Yang1, Yanan Zhang1, Jun Liu1, Liang Zheng2 & Bingbing Zha1

1Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China; 2Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

There are potential benefits and risks to receive Granulocyte-Colony Stimulating Factor (G-CSF) as a general treatment in hospital. To assess the clinical effect of G-CSF or non-G-CSF on recovery duration for agranulocytosis patients with hyperthyroidism, we analyzed the overall clinical outcomes by meta-analysis. We included published seven retrospective studies and 1 prospective study. Individual data were obtained from eight trials (376 patients: 215 with G-CSF, 161 with non-G-CSF treatment). The heterogeneity was acceptable (I2=47.4%, P=0.055) and the fixed-effect model was applicable. Compared with the non-G-CSF group, G-CSF group presented with shorter recovery duration with weighted mean difference (WMD)=−2.94d, 95% confidence interval (95% CI): −3.90, −1.97 (Z=5.98 P=0.000). However, we found that different regions and recovery criteria influence the results. European and South American patients have significant clinical outcome with WMD=−4.34d (95% CI: −7.37, −1.31), compared to Asian patients with WMD=−2.77d (95% CI: −3.82, −1.72). At the same time, varied recovery criteria, the duration of granulocyte count over 1.0 or 1.5×109/l with −4.34d (95% CI−7.37, −1.31) present better treatment effect in our analysis. So, we concluded that G-CSF was able to significantly shorten the recovery duration of hyperthyroidism patients accompanied with agranulocytosis, especially in Europe and South America region and for granulocyte count over 1.0 or 1.5×109/l.

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