Benefit of simultaneous rhG-CSF and methylprednisolone 'pulse' therapy for methotrexate-induced bone marrow failure in rheumatoid arthritis.
A 74-year-old female with seropositive rheumatoid arthritis developed severe bone marrow failure after the treatment with very low-dose methotrexate (5 mg/week for 3 weeks). Hematological data showed severe pancytopenia with 0% neutrophils and bone marrow disclosed thoroughly hypocellular marrow. Shortly after the treatment with simultaneous rhG-CSF and methylprednisolone 'pulse' therapy, pancytopenia was ameliorated and bone marrow examination revealed hypercellular marrow with increasing maturation of hematopoietic components. Hematological parameters were maintained within the normal range with a low dose of prednisolone.
Kondo
H
H
Department of Medicine, Shimizu Kousei Hospital, Shizuoka, Japan.
Date
Y
Y
D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001855:Bone Marrow Diseases / Q000139:chemically induced* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008775:Methylprednisolone / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage
D018501:Antirheumatic Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D008775:Methylprednisolone; D008727:Methotrexate