Colony-stimulating factors adverse effects

A 27-year-old man taking clozapine, benperidol, and risperidone developed severe extrapyramidal adverse effects and had insufficient antipsychotic effects and was given olanzapine, rapidly increasing to 40 mg/day. After 9 days of treatment with olanzapine, his total white cell count fell from 5.8 x 109/1 to 3.4 x 109/1, and olanzapine was withdrawn 3 days later his neutrophil count was 0.39 x 109/1. He developed a fever of 39.5°C and was treated with granulocyte colony-stimulating factor. 

Colony-stimulating factors have been used to treat and prevent the adverse hematological effects of busulfan (17,18). 

Few studies have directly compared the safety of the various available colony-stimulating factors. The frequency and severity of adverse effects associated with the prophylactic use of filgrastim (a bacterial cell-derived G-CSF) or sargramostim (a yeast cell-derived GM-CSF) have been assessed in a retrospective review of the medical records of 490 cancer patients from 10 centers (9). 

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