[Acute respiratory failure associated with G-CSF-induced leukocyte recovery in three patients with preceding infection].
Acute respiratory failure (ARF) occurred at the time of leukocyte recovery promoted by granulocyte colony-stimulating factor (G-CSF) in three patients with the preceding infection (S. aureus pneumonia, varicella zoster, and P. aeruginosa bacteremia, respectively) which had developed during leukopenia after cancer chemotherapy. G-CSF was used for 4 to 6 days, and the leukocyte counts at onset of ARF were 19,300/microliter, 11,300/microliter, and 4,100/microliter, respectively. All of the three patients received high-dose methylprednisolone and the artificial respiration was used in two. Consequently two patients responded well and survived, but one died of respiratory failure 2 weeks after occurrence of ARF. Autopsy of the dead case revealed mild interstitial pneumonia in the both lungs together with bacterial pneumonia in the right lobe. These cases indicate that G-CSF-induced leukocyte recovery can cause severe ARF in patients with precending infection. Therefore, G-CSF should be administered very carefully to granulocytopenic patients with infection.
Sakai
C
C
Division of Hematology & Chemotherapy, Chiba Cancer Center Hospital.
Nakaseko
C
C
Takagi
T
T
D000208:Acute Disease; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D016470:Bacteremia / Q000150:complications; D002644:Chickenpox / Q000150:complications; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects*; D006801:Humans; D007239:Infections / Q000150:complications*; D007970:Leukopenia / Q000139:chemically induced / Q000628:therapy*; D017563:Lung Diseases, Interstitial / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000150:complications; D011552:Pseudomonas Infections / Q000150:complications; D012131:Respiratory Insufficiency / Q000209:etiology*; D013203:Staphylococcal Infections / Q000150:complications
D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor