Leukocytosis due to markedly elevated granulocyte-colony stimulating factor levels in a patient with endometrial cancer: Case report and literature review

Clark, Leslie H.; Moll, Stephan; Houghton, Damon E.; O'Connor, Siohban; Soper, John T.

doi:10.1016/j.gore.2017.01.007

Cited by 6 publications

(4 citation statements)

References 18 publications

(35 reference statements)

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“…The elevated plasma values were mainly reported in highly advanced nonendometrioid EC with poor prognosis or a large tumor burden [51][52][53]. In our study, EC patients had lower G-CSF plasma levels; however, the median values of both cancer and control groups remained relatively low compared to the case reports with advanced type 2 EC, evaluated via the commercially available ELISA kit [54].…”

Section: Discussioncontrasting

confidence: 59%

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Roškar

Klančič

Knific

et al. 2021

JCM

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Preoperative determination of the extent of endometrial cancer (EC) would avoid the complications associated with radical surgery. Screening of patients’ plasma biomarkers might enable a more precise diagnosis of EC and a tailored treatment approach. This prospective case-control monocentric pilot study included 76 postmenopausal women (38 endometrioid EC patients and 38 control patients with benign gynecological conditions), and 37 angiogenic factors (AFs) were investigated as potential biomarkers for EC. AF concentrations in preoperative plasma samples were measured using Luminex xMAP™ multiplexing technology. The plasma levels of sTie-2 and G-CSF were significantly lower in EC compared to control patients, whereas the plasma levels of leptin were significantly higher in EC patients. Neuropilin-1 plasma levels were significantly higher in patients with type 2 EC (grade 3) compared to patients with lower grade cancer or controls. Follistatin levels were significantly higher in patients with lymphovascular invasion, and IL-8 plasma levels were significantly higher in patients with metastases. If validated, the plasma concentrations of the indicated AFs could represent an important additional diagnostic tool for the early detection and characterization of EC. This could guide the decision-making on the extent of surgery. Further studies with larger patient numbers are currently ongoing.

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Section: Discussioncontrasting

confidence: 59%

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Roškar

Klančič

Knific

et al. 2021

JCM

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“…Patients with hyperleukemia also showed a tendency to metastasize which might be related to the formation of tumor pre metastatic niches mediated by tumor secreted G-CSF and myeloid derived suppressor cells (MDSC). Clark et al 10 reported a 65-year-old PLR symptom with recurrent endometrial cancer after surgical treatment appeared abnormal leukocyte elevation (51.4 × 10 9 /L) and red blood cells/platelets myelosuppression during chemotherapy with elevated GCSF level. Eight months after PLR occurred, the patient died due to the intolerance to chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

The co-occurrence of leukemoid reaction and hypercalcemia in a patient with endometrial cancer: A case report and literature review

et al. 2021

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Paraneoplastic syndromes are rarely seen in gynecological tumors especially in endometrial cancer. Early identification of paraneoplastic syndromes plays a significant role in the treatment and prognosis of cancer. Here, we reported a rare case with endometrial cancer with a 2.7 cm × 2.2 cm × 3.4 cm lesion in the posterior cervix presenting leukemoid reaction and hypercalcemia as paraneoplastic syndromes simultaneously. During the progress of the endometrial cancer, her leukocyte level rose up to 60.7 × 109/L after anti-infection treatment. Meanwhile, the patient represented a series of severe clinical situation including hypercalcemia, hypokalemia, metabolic alkalosis. and respiratory failure. Finally, the patient died of respiratory circulatory failure 2 weeks later. In addition to symptomatic treatment, possible treatment targeted on the primary tumor as early as possible might help to improve the clinical prognosis.

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“…Generally, in solid cancer, excessive cytokine generation, sometimes causing leukemoid reactions, may emanate from cancer cells or from cells reacting to the malignancy. 2,7,36 By crosstalk mechanisms, myeloproliferation in cancer can be important for tumor progression and has been proposed as a new target of therapy. 7 An association specifically between absolute monocytosis and poor prognosis has been found for a diversity of malignancies.…”

Section: Discussionmentioning

confidence: 99%

Cytokine Measurements for Diagnosing and Characterizing Leukemoid Reactions and Immunohistochemical Validation of a Granulocyte Colony-Stimulating Factor and CXCL8-Producing Renal Cell Carcinoma

et al. 2018

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Background:Various paraneoplastic syndromes are encountered in renal cell carcinomas. This case report illustrates that a paraneoplastic leukemoid reaction may precede the diagnosis of renal cell carcinoma and be explained by cytokine production from the cancer cells.Case presentations:A 64-year-old man was referred for hematology workup due to pronounced leukocytosis. While being evaluated for a possible hematologic malignancy as the cause, he was found to have a metastasized renal cell carcinoma, and hyperleukocytosis was classified as a leukemoid reaction. A multiplex panel for measurement of 25 serum cytokines/chemokines showed highly elevated levels of granulocyte colony-stimulating factor (G-CSF) and CXCL8 (C-X-C-motif chemokine ligand 8, previously known as interleukin [IL]-8). By immunohistochemistry it was shown that the renal carcinoma cells expressed both these cytokines. Two additional, consecutive patients with renal cell carcinoma with paraneoplastic leukocytosis also showed elevated serum levels of CXCL8, but not of G-CSF. Nonparametric statistical evaluation showed significantly higher serum concentrations of CXCL8, IL-6, IL-10, monocyte chemoattractant protein 1 (MCP-1), and tumor necrosis factor, but lower interferon gamma (IFN-γ) and IL-1α, for the 3 renal cell carcinoma cases compared with healthy blood donors.Conclusions:In suspected paraneoplastic leukocytosis, multiplex serum cytokine analyses may facilitate diagnosis and provide an understanding of the mechanisms for the reaction. In the index patient, combined G-CSF and CXCL8 protein expression by renal carcinoma cells was uniquely documented. A rapidly fatal course was detected in all 3 cases, congruent with the concept that autocrine/paracrine growth signaling in renal carcinoma cells may induce an aggressive tumor phenotype. Immune profiling studies could improve our understanding for possible targets when choosing therapies for patients with metastatic renal cell carcinoma.

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Leukocytosis due to markedly elevated granulocyte-colony stimulating factor levels in a patient with endometrial cancer: Case report and literature review

Abstract: HighlightsGranulocyte-colony stimulating factor (GCSF) secretion by gynecologic tumors is rare.Elevations in serum GCSF can be seen in the absence of tumor GSCF secretion.Extreme leukocytosis is associated with autocrine tumor growth and poor prognosis.

Cited by 6 publications

References 18 publications

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

Tie-2, G-CSF, and Leptin as Promising Diagnostic Biomarkers for Endometrial Cancer: A Pilot Study

The co-occurrence of leukemoid reaction and hypercalcemia in a patient with endometrial cancer: A case report and literature review

Cytokine Measurements for Diagnosing and Characterizing Leukemoid Reactions and Immunohistochemical Validation of a Granulocyte Colony-Stimulating Factor and CXCL8-Producing Renal Cell Carcinoma

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