Hemophagocytosis exacerbated by G-CSF/GM-CSF treatment in a patient with myelodysplasia.
We describe a 75-year-old man with neutropenia in whom bone marrow aspirate and biopsy demonstrated hemophagocytosis associated with myelodysplasia (MDS). Therapy with granulocyte-colony stimulating factor (G-CSF) and granulocyte-monocyte-colony stimulating factor (GM-CSF) caused splenomegaly and severe thrombocytopenia, which recurred upon rechallenge. We propose that myeloid growth factors may be detrimental in patients with MDS-associated hemophagocytosis.
Wang
Sa
S
Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA.
Degar
Barbara A
BA
Zieske
Arthur
A
Shafi
Nelofar Q
NQ
Rose
Michal G
MG
D000368:Aged; D001772:Blood Cell Count; D001853:Bone Marrow / Q000473:pathology; D017809:Fatal Outcome; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D015616:Histiocytosis, Non-Langerhans-Cell / Q000097:blood / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D009503:Neutropenia / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D011994:Recombinant Proteins; D013156:Splenectomy; D013921:Thrombocytopenia / Q000209:etiology* / Q000628:therapy
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor