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首页> 外文期刊>Journal of the American Academy of Child and Adolescent Psychiatry >Hematological Adverse Events in Clozapine-Treated Children and Adolescents.
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Hematological Adverse Events in Clozapine-Treated Children and Adolescents.

机译：经氯氮平治疗的儿童和青少年的血液学不良事件。

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OBJECTIVE:: To retrospectively examine rates of hematological adverse events (HAEs) in psychiatrically ill, hospitalized children treated with clozapine. METHOD:: Clozapine treatment was administered in an open-label fashion using a flexible titration schedule, and data from weekly complete blood counts was obtained. The rate of neutropenia and agranulocytosis (HAEs) development was determined for 172 eligible patients (mean age at clozapine initiation, 15.03 +/- 2.13 years) with a median observation period of 8 months. RESULTS:: Neutropenia (absolute neutrophil count <1,500/mm) developed in 23 (13%) patients and agranulocytosis (absolute neutrophil count <500/mm) in one (0.6%) patient. The cumulative probability of developing an initial HAE at 1 year of clozapine treatment was 16.1% (95% confidence interval 9.7%-22.5%). Eleven (48%) of 24 patients who developed an HAE were successfully rechallenged on clozapine. Eight (5%) of 172 patients from this sample eventually discontinued clozapine because of an HAE (one agranulocytosis, seven neutropenia). CONCLUSIONS:: The occurrence of HAEs is a significant risk associated with the administration of clozapine. However, in this sample, few children actually discontinued therapy because of an HAE and the incidence of agranulocytosis does not appear higher than what has been reported in the adult literature.
机译：目的：回顾性研究接受氯氮平治疗的精神病住院患者的血液学不良事件（HAE）发生率。方法：使用灵活的滴定时间表以开放标签的方式进行氯氮平治疗，并从每周全血细胞计数中获取数据。确定了172名合格患者的中性粒细胞减少和粒细胞缺乏症（HAEs）发生率（氯氮平开始时的平均年龄：15.03 +/- 2.13岁），中位观察期为8个月。结果：23名（13％）患者出现中性粒细胞减少（绝对嗜中性粒细胞计数<1,500 / mm），一名（0.6％）患者发生粒细胞缺乏症（绝对嗜中性粒细胞计数<500 / mm）。氯氮平治疗1年后发生初始HAE的累积概率为16.1％（95％置信区间为9.7％-22.5％）。 24名发生HAE的患者中有11名（48％）成功接受氯氮平治疗。该样本的172名患者中有八名（5％）由于发生HAE而终止使用氯氮平（一名粒细胞缺乏症，七个中性粒细胞减少症）。结论：HAE的发生是与氯氮平给药相关的重大风险。但是，在该样本中，很少有儿童因HAE而实际停止治疗，并且粒细胞缺乏症的发生率似乎未高于成人文献中的报道。

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