Florid histiocytic hemophagocytosis following therapy with long acting G-CSF (pegfilgrastim).
We describe a case of histiocytic hemophagocytosis and increase in blasts in the bone marrow after administration of long acting G-CSF (pegfilgrastim) in a 71-year-old man with underlying myelodysplasia. Pegfilgrastim was discontinued, with resolution of the hemophagocytosis and marked decrease in blasts from 30 to 5%. We postulate that pegfilgrastim provided a continuous stimulation of the monocyte/macrophage system, resulting in histiocytic hemophagocytosis. We recommend caution in defining indications for the use of long acting preparations of G-CSF.
Glasser
Lewis
L
Department of Pathology and Laboratory Medicine, Brown Medical School, Rhode Island Hospital, Providence, Rhode Island 02903, USA. LGlasser@Lifespan.org
Legolvan
Mark
M
Horwitz
Harold M
HM
D000368:Aged; D001706:Biopsy; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use*; D015614:Histiocytosis / Q000139:chemically induced* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D009436:Neural Tube Defects / Q000188:drug therapy / Q000473:pathology; D010587:Phagocytosis / Q000187:drug effects*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D013997:Time Factors; D017211:Treatment Failure
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim