Drug-induced agranulocytosis: a disproportionality analysis and umbrella review

作者：Yajie Lu, Bin Wu, Kunyu Li, Zhonglin Liu, Yuxi Chen, Ting Xu · 发表于：Frontiers in Pharmacology · 年份：2025 · DOI：10.3389/fphar.2025.1641747 · 被引用次数：2 · 研究领域：Blood disorders and treatments、Acute Myeloid Leukemia Research、Multiple Myeloma Research and Treatments

Background: Drug-induced agranulocytosis (DIA) is a rare but life-threatening hematologic disorder that demands increased clinical and research attention. This study aimed to provide the current overview of DIA for clinical guidance. Methods: Using real-world data from FDA Adverse Event Reporting System (FAERS), we performed a disproportionality analysis to identify the drugs associated with agranulocytosis, employing the information component and reporting odds ratio algorithms. Logistic analysis was conducted to explore the confounding factors of DIA. Time-to-onset analysis was implemented to compare the adverse event onset time among different drugs. To comprehensively supplement and corroborate our disproportionality findings, we further conducted an umbrella review of systematic reviews (SRs). Five electronic databases were searched with SRs addressing DIA as an included adverse event. Two independent reviewers performed literature screening, data extraction, and quality assessment according to the preferred reporting items for systematic reviews and meta-analysis statement. The results of the included SRs were synthesized using qualitative analysis. Results: The disproportionality analysis revealed that most identified DIA signals were for anticancer drugs. The top-five drugs with DIA signals by case number were methotrexate (6,462 cases), lenalidomide (5,722 cases), rituximab (5,691 cases), doxorubicin (4,391 cases), and carboplatin (4,371 cases). High-risk drugs (e.g....