[Two cases of malignant lymphoma with high fever and C-reactive protein (CRP) elevation after treatment with granulocyte colony-stimulating factor (G-CSF)]

Gan To Kagaku Ryoho. 2006 Jan;33(1):73-7.
[Article in Japanese]

Abstract

We present two cases of malignant lymphoma that developed a high fever that eventually reached an extremely high 38.9 degrees C. The C-reactive protein( CRP) elevation also climbed to a very high 12.2 mg/dl after treatment with granulocyte colony-stimulating factor (G-CSF). In the one case, after stem cells were mobilized with CHASER therapy (cyclophosphamide, cytarabine, etoposide, dexamethasone and rituximab) followed by G-CSF (filgrastim 600 microg/day) subcutaneous daily, the serum CRP level rose to a maximum of 5.6 mg/dl, with a maximum fever elevation of 38.9 degrees C. In the other case, after the subject was given CHASE therapy followed by subcutaneous treatment with G-CSF (filgrastim 75 microg/day) daily, the maximum serum CRP level was 12.2 mg/dl along with a maximum fever of 38.9 degrees C. Although no infection was found in either case, multiple antibacterial agents were ineffective;after discontinuation of G-CSF, fever dissipated and the serum CRP level became negative. G-CSF induces the proliferation and differentiation of neutrophils and also causes the mobilization of mature neutrophils from hematopoietic tissues. With the increasing propensity to G-CSF, we must keep in mind the possibility of such adverse reactions so as to serve the overall best interests of the patient.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • C-Reactive Protein / metabolism*
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Dexamethasone / administration & dosage
  • Doxorubicin / administration & dosage
  • Drug Administration Schedule
  • Etoposide / administration & dosage
  • Female
  • Fever / etiology*
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / adverse effects*
  • Hematopoietic Stem Cell Mobilization
  • Humans
  • Lymphoma / blood
  • Lymphoma / drug therapy*
  • Lymphoma, Mantle-Cell / blood
  • Lymphoma, Mantle-Cell / drug therapy*
  • Male
  • Middle Aged
  • Prednisone / administration & dosage
  • Recombinant Proteins
  • Rituximab
  • Vincristine / administration & dosage

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Recombinant Proteins
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Rituximab
  • Vincristine
  • Etoposide
  • Dexamethasone
  • Doxorubicin
  • Cyclophosphamide
  • C-Reactive Protein
  • Filgrastim
  • Prednisone

Supplementary concepts

  • CHASE protocol
  • CHOP protocol