Aortitis after switching short-acting granulocyte colony-stimulating factors in a lymphoma patient with HLA-B52

Int J Hematol. 2024 May;119(5):608-612. doi: 10.1007/s12185-024-03744-w. Epub 2024 Mar 23.

Abstract

Aortitis is a rare adverse event of granulocyte colony-stimulating factor (G-CSF) treatment. Several previous studies have described recurrent aortitis caused by re-administration of the same G-CSF. However, no previous studies have examined the safety of switching between short-acting G-CSFs in patients who develop aortitis. We report the case of a 55-year-old man with refractory diffuse large B-cell lymphoma, who developed G-CSF-associated aortitis. The aortitis was triggered by filgrastim and recurred after treatment with lenograstim. The patient possessed human leukocyte antigen B52, which has been implicated in Takayasu arteritis. In addition, a drug-induced lymphocyte stimulation test for lenograstim performed upon detection of recurrent G-CSF-associated aortitis produced a positive result. Our case suggests that switching from one short-acting G-CSF to another does not prevent recurrence of G-CSF-associated aortitis. Although the etiology of G-CSF-associated aortitis has not been fully elucidated, our case also suggests that some patients may be genetically predisposed to aortitis.

Keywords: Aortitis; Diffuse large B-cell lymphoma; Human leukocyte antigen; Short-acting granulocyte colony-stimulating factor.

Publication types

  • Case Reports

MeSH terms

  • Aortitis* / chemically induced
  • Aortitis* / etiology
  • Drug Substitution
  • Filgrastim / administration & dosage
  • Filgrastim / adverse effects
  • Granulocyte Colony-Stimulating Factor* / administration & dosage
  • Granulocyte Colony-Stimulating Factor* / adverse effects
  • HLA-B52 Antigen* / adverse effects
  • Humans
  • Lenograstim
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Male
  • Middle Aged
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use

Substances

  • Granulocyte Colony-Stimulating Factor
  • HLA-B52 Antigen
  • Filgrastim
  • Lenograstim
  • Recombinant Proteins