Skip to main content
SpringerLink
Log in

Filgrastim Treatment of Acute Myelogenous Leukemia (M7) Relapse after Allogeneic Peripheral Stem Cell Transplantation Resulting in Both Graft-versus-Leukemia Effect with Cytogenetic Remission and Chronic Graft-versus-Host Disease Manifesting as Polyserositis and Subsequent Bronchiolitis Obliterans with Organizing Pneumonia

  • Case Report
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

Filgrastim (granulocyte colony-stimulating factor) has recently been reported to successfully treat patients with leukemic relapse after allogeneic peripheral stem cell transplantation (PSCT). However, the majority of the patients who responded also developed graft-versus-host disease (GVHD). Polyserositis as a manifestation of GVHD is a rare phenomenon. We report the first case of polyserositis following the use of filgrastim to treat a patient with acute myelogenous leukemia (M7), who had relapsed after an initially successful allogeneic PSCT. The polyserositis manifested with effusions and was initially controlled with high doses of steroids and pericardial stripping; however, after a quiescent period the patient eventually developed bronchiolitis obliterans with organizing pneumonia that required additional immunosuppressive therapy. We review the literature on GVHD-associated polyserositis and offer potential explanations for its pathogenesis.Int J Hematol. 2002; 76: 360-364.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mortimer J, Blinder MA, Schulman S, et al. Relapse of acute leukemia after marrow transplantation: natural history and results of subsequent therapy.J Clin Oncol. 1989; 7: 50–57.

    Article  PubMed  CAS  Google Scholar 

  2. Bishop MR, Tarantolo SR, Pavletic ZS, et al. Filgrastim as an alternative to donor leukocyte infusion for relapse after allogeneic stem-cell transplantation.J Clin Oncol. 2000; 18: 2269–2272.

    Article  PubMed  CAS  Google Scholar 

  3. Giralt S, Escudier S, Kantarjian H, et al. Preliminary results of treatment with filgrastim for relapse of leukemia and myelodysplasia after allogeneic bone marrow transplantation.N Engl J Med. 1993; 329: 757–761.

    Article  PubMed  CAS  Google Scholar 

  4. Curral A, Sanz GF, Sanz MA. Filgrastim for the treatment of leukemia relapse after bone marrow transplantation.Bone Marrow Transplant. 1996; 18: 817–819.

    Google Scholar 

  5. Noble PW. The pulmonary complications of bone marrow transplantation in adults.West J Med. 1989; 150: 443–449.

    PubMed  PubMed Central  CAS  Google Scholar 

  6. Einsele H, Ehninger G, Vallbracht A, et al. Isolated pericardial relapse following allogeneic bone marrow transplantation for acute myelogenous leukemia.Bone Marrow Transplant. 1989; 4: 323–325.

    PubMed  CAS  Google Scholar 

  7. Veys PA, McAvinchey R, Rothman MT, Mair GHM, Newlant AC. Pericardial effusion following conditioning for bone marrow transplantation in acute leukaemia.Bone Marrow Transplant. 1987; 2: 213–216.

    PubMed  CAS  Google Scholar 

  8. Oeda E, Shinohara K, Kamel S, et al. Capillary leak syndrome likely the result of granulocyte colony-stimulating factor after high-dose chemotherapy.Intern Med. 1994; 33: 115–119.

    Article  PubMed  CAS  Google Scholar 

  9. de Azevedo AM, Tabak DG. Life-threatening capillary leak syndrome after G-CSF mobilization and collection of peripheral blood progenitor cells for allogeneic transplantation.Bone Marrow Transplant. 2001; 28: 311–312.

    Article  PubMed  Google Scholar 

  10. Toren A, Nagler A. Massive pericardial effusion complicating the course of chronic graft-versus-host disease (cGVHD) in a child with acute lymphoblastic leukemia following allogeneic bone marrow transplantation.Bone Marrow Transplant. 1997; 20: 805–807.

    Article  PubMed  CAS  Google Scholar 

  11. Ueda T, Manabe A, Kikuchi A, et al. Massive pericardial and pleural effusion with anasarca following allogeneic bone marrow transplantation.Int J Hematol. 2000; 71: 394–397.

    PubMed  CAS  Google Scholar 

  12. Seber A, Khan SP, Kersey JH. Unexplained effusion; association with allogeneic bone marrow transplantation and acute or chronic graft-versus-host disease.Bone Marrow Transplant. 1996; 17: 207–211.

    PubMed  CAS  Google Scholar 

  13. Giralt SA, Champlin RE. Leukemia relapse after allogeneic bone marrow transplantation: a review.Blood. 1994; 84: 3603–3612.

    PubMed  CAS  Google Scholar 

  14. Collins RH Jr, Shpilberg O, Drobyski WR, et al. Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone marrow transplantation.J Clin Oncol. 1997; 15: 433–444.

    Article  PubMed  Google Scholar 

  15. Pan L, Delmonte J Jr, Jalonen CK, et al. Pretreatment of donor mice with granulocyte colony-stimulating factor polarizes donor T lymphocytes toward Type-2 cytokine production and reduces severity of experimental graft-versus-host disease.Blood. 1995; 86: 4422–4429.

    PubMed  CAS  Google Scholar 

  16. Pan L, Takanori T, Geoffrey RH, et al. Granulocyte colonystimulating factor-mobilized allogeneic stem cell transplantation maintains graft-versus-leukemia effects through a perforindependent pathway while preventing graft-versus-host disease.Blood. 1999; 93: 4071–4077.

    PubMed  CAS  Google Scholar 

  17. Collins RH, Rogers RR, Bennett M, et al. Hematologic relapse of chronic myelogenous leukemia following allogeneic bone marrow transplantation: apparent graft-versus-leukemia effect following abrupt discontinuation of immunosuppression.Bone Marrow Transplant. 1992; 10: 391–395.

    PubMed  Google Scholar 

  18. Sherer Y, Shoenfeld Y. Autoimmune diseases and autoimmunity post-bone marrow transplantation.Bone Marrow Transplant. 1998; 22: 873–881.

    Article  PubMed  CAS  Google Scholar 

  19. Bensinger WI, Martin PJ, Storer B, et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers.N Engl J Med. 2001; 344: 175–181.

    Article  PubMed  CAS  Google Scholar 

  20. Isselbacher KJ, Martin JB, Fauci A, Baraunwald E, eds.Harrison’s Principles of Internal Medicine. 13th edition. New York, NY: McGraw-Hill; 1994.

Download references

Author information

Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Internal Medicine, University of California, Davis, California, USA

    L. Law, J. Tuscano, T. Wun, K. Ahlberg & C. Richman

Authors
  1. L. Law
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Tuscano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Wun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Ahlberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. Richman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Richman.

About this article

Cite this article

Law, L., Tuscano, J., Wun, T. et al. Filgrastim Treatment of Acute Myelogenous Leukemia (M7) Relapse after Allogeneic Peripheral Stem Cell Transplantation Resulting in Both Graft-versus-Leukemia Effect with Cytogenetic Remission and Chronic Graft-versus-Host Disease Manifesting as Polyserositis and Subsequent Bronchiolitis Obliterans with Organizing Pneumonia. Int J Hematol 76, 360–364 (2002). https://doi.org/10.1007/BF02982697

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02982697

Key words

Search

Navigation