title: Critically Ill Patient Due to Pneumonitis Secondary to the Use of Filgrastim.
abstract: Filgrastim is a granulocyte colony-stimulating factor commonly used in the prophylaxis and treatment of neutropenia associated with chemotherapy in cancer patients. It is a well-tolerated and safe drug but some unusual serious adverse effects may occur. We expose a case of a 37-year-old woman who was hospitalized with severe pancitopenia after the first cycle of chemotherapy with a cisplatin doublet and bevacizumab. Filgrastim was administered for 3 days with the aim of increasing neutrophils and not delay the next chemotherapy cycle. Due to acute respiratory failure she was transferred to the Intensive Care Unit for symptomatic control where required oxygen therapy. Fungal and bacterial culture were made and so blood serologies, all of them were negative. It was diagnosed as pneumonitis secondary to a probable side effect of filgrastim. Although the case was resolved properly it is important monitor the administration of filgrastim because of the severity of these events.
authors.affiliation: 1Department of Pharmacy and 2Medical Oncology, Hospital Universitario Puerta de Hierro, Madrid, Spain.
authors.forename: Belén Escudero
authors.initials: BE
authors.lastname: Vilaplana
authors.forename: Julia Ruiz
authors.initials: JR
authors.lastname: Gutiérrez
authors.forename: Blanca Cantos Sánchez
authors.initials: BC
authors.lastname: de Ibarguen
authors.forename: Marta Manso
authors.initials: MM
authors.lastname: Manrique
authors.forename: Amelia Sánchez
authors.initials: AS
authors.lastname: Guerrero
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D000068258:Bevacizumab / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage; D016638:Critical Illness; D005260:Female; D000069585:Filgrastim / Q000009:adverse effects*; D006401:Hematologic Agents / Q000009:adverse effects*; D006801:Humans; D010102:Oxygen Inhalation Therapy; D010198:Pancytopenia / Q000139:chemically induced / Q000188:drug therapy*; D011014:Pneumonia / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy; D013902:Radiography, Thoracic; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy
chemical_list: D006401:Hematologic Agents; D000068258:Bevacizumab; D000069585:Filgrastim; D002945:Cisplatin