A retrospective analysis on arteritis after administration of granulocyte colony-stimulating factor

Aortitis Associated with Prophylactic Short-acting Granulocyte Colony-stimulating Factor Administration: A Case Report and Review of the Literature

“…This is in response to recent guidelines that recommend prophylactic treatment with G-CSF for high-risk FN ( 30 , 31 ). A previous study reported no occurrence of filgrastim-associated aortitis in any of 490 injections over 5 years, with filgrastim administered after the neutrophil count dropped below 500 /μL ( 8 ). Since reported cases of G-CSF-associated aortitis in NHL patients, in which the usage of G-CSFs is delineated, were all caused by prophylactic G-CSFs ( Table ) ( 5 - 9 ), we may infer that our present case represents another aortitis case associated with prophylactic G-CSF administration.…”

“…Of note, the long-acting G-CSF pegfilgrastim was used instead of a short-acting G-CSF in most previous cases (11/13 cases). Indeed, Sasaki et al conducted a single-institution retrospective study of G-CSF-associated aortitis and reported that the incidence of aortitis was significantly higher when long-acting pegfilgrastim was administered (5 cases of aortitis out of 669 administrations, 0.75%) than when short-acting filgrastim was administered (no aortitis out of 490 total administrations, 0.0%) ( 8 ). These previous findings suggest two possibilities: 1) long-acting pegfilgrastim is more likely to induce aortitis than short-acting filgrastim, or 2) G-CSF usage as prophylactic treatment (i.e., G-CSF initiation before the onset of neutropenia) is more likely to induce aortitis than as reactive treatment (i.e., G-CSF initiation after the onset of neutropenia).…”

“…G-CSFs are safe and well-tolerated, but serious adverse events, such as acute lung injury, acute coronary syndrome, and disseminated intravascular coagulation, have been reported (4). Among these complications, aortitis is rare, and only a few cases have been reported during chemotherapy for NHL (5)(6)(7)(8)(9)(10).…”