Filgrastim induced thrombocytopenia

BMJ Case Rep. 2020 Jun 30;13(6):e234584. doi: 10.1136/bcr-2020-234584.

Abstract

Drug-induced thrombocytopenia (DITP) is suggested by severe thrombocytopenia with subsequent recovery of platelet count after removal of the offending drug. The diagnosis is ascertained when there is reproducibility of thrombocytopenia with repeated exposure. Filgrastim is used during peripheral blood progenitor cell harvest during autologous stem cell transplantation in the setting of multiple myeloma to prolong event-free survival and overall mortality. The following case illustrates all of the suggestive features of DITP after filgrastim exposure during elective stem cell harvest. Due to the inability to tolerate filgrastim, autologous stem cell transplant was aborted in this patient and he was maintained on induction chemotherapy.

Keywords: Haematology (incl blood transfusion); cancer - see oncology; haematology (drugs and medicines); malignant and benign haematology; unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Filgrastim* / administration & dosage
  • Filgrastim* / adverse effects
  • Hematologic Agents / administration & dosage
  • Hematologic Agents / adverse effects
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Induction Chemotherapy / methods
  • Lumbar Vertebrae* / diagnostic imaging
  • Lumbar Vertebrae* / pathology
  • Male
  • Middle Aged
  • Multiple Myeloma* / diagnosis
  • Multiple Myeloma* / drug therapy
  • Pelvic Bones* / diagnostic imaging
  • Pelvic Bones* / pathology
  • Platelet Count / methods
  • Preoperative Care / adverse effects
  • Preoperative Care / methods
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / diagnosis
  • Transplantation, Autologous / methods
  • Withholding Treatment

Substances

  • Hematologic Agents
  • Filgrastim