title: Fatal stimulation of acute myeloid leukemia blasts by pegfilgrastim.
abstract: We herein report the case of a male patient with acute myeloid leukemia with fatal outcome attributable to pharmacokinetics of pegfilgrastim.
  
  
  METHODS
  An unexplained blast proliferation in a patient with acute myeloid leukemia following cytotoxic induction chemotherapy was investigated in depth. Myeloblast hyperstimulation was likely related to pegfilgrastim, the long half-life of which extended the duration of side-effects, resulting in massive and rapidly fatal leukemia cell proliferation.
  
  
  CONCLUSIONS
  Pegfilgrastim can cause unexpected deleterious effects in acute myeloid leukemia. We, thus, recommend administering drugs with a shorter half-life, such as filgrastim or lenograstim, to reduce infection incidence in patients receiving myelosuppressive chemotherapy associated with a clinically significant incidence of febrile neutropenia.
authors.affiliation: Pharmacy, University Hospital of Strasbourg, Strasbourg, France celine.duval@chru-strasbourg.fr.
authors.forename: Celine
authors.initials: C
authors.lastname: Duval
authors.affiliation: Department of Oncology and Hematology, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Boucher
authors.affiliation: Department of Oncology and Hematology, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Moulin
authors.affiliation: Pharmacy, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Gourieux
authors.affiliation: Hematology Laboratory, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Mauvieux
authors.affiliation: Pharmacy, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Leveque
authors.affiliation: Department of Oncology and Hematology, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Raoul
authors.initials: R
authors.lastname: Herbrecht
mesh_terms: D001752:Blast Crisis / Q000139:chemically induced*; D049109:Cell Proliferation / Q000187:drug effects*; D017809:Fatal Outcome; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011379:Prognosis; D011994:Recombinant Proteins / Q000009:adverse effects
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim
keywords: Pegfilgrastim; acute myeloid leukemia; fatal effect