Fatal Pulmonary Toxicity Related to the Administration of Granulocyte Colony-Stimulating Factor in Amyloidosis: A Report and Review of Growth Factor-Induced Pulmonary Toxicity

Gertz, Morie A.; Lacy, Martha Q.; Björnsson, Jóhannes; Litzow, Mark R.

doi:10.1089/15258160050196678

Cited by 38 publications

(16 citation statements)

References 42 publications

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“…The low urine sodium and hypotension were consistent with the pathophysiology of CLS. While AL patients can develop CLS, CLS was probably not the only reason AKI was so common in this study [16]. More than half of the patient with AL present with either proteinuria, renal insufficiency or both [17].…”

Section: Discussionmentioning

confidence: 98%

“…When patients were classified based on AKIN criteria, seven (24.1%) had AKIN Stage 1, six (20.7%) AKIN Stage 2, and 15 (51.7%) AKIN Stage 3. Recovery of renal function was noted starting at day 18 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Based on the last Scr, 60% were within 25% of baseline and 80% were within 50% of baseline.…”

Section: Engraftment Syndromementioning

confidence: 99%

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Acute kidney injury during leukocyte engraftment after autologous stem cell transplantation in patients with light‐chain amyloidosis

et al. 2011

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Engraftment syndrome (ES) is a complication of hematopoietic stem cell transplantation characterized by fever, rash, and non-cardiogenic pulmonary edema. Acute kidney injury (AKI) has been recognized but is considered a minor criterion in one and excluded another definition of ES. We have noted a high incidence of AKI in patients with immunoglobulin light-chain amyloidosis (AL) undergoing autologous stem cell transplant (ASCT) around the time of leukocyte engraftment. This study was conducted to further investigate the relationship between AKI and ES. Data were collected from 377 AL patients who underwent ASCT from 7/1997 to 10/2009. Patients who experienced an elevation of serum creatinine >0.5 mg/dL within 4 days of leukocyte engraftment and anyone who presented with signs associated with ES regardless of renal manifestations were included. Forty-one patients met criteria. Twelve were excluded for positive cultures (10), acute interstitial nephritis (1), and acute cellular rejection (1). In addition to AKI (93.1%), patients also exhibit fever (82.7%), hypotension (51.7%), rash (48.2%), edema (93.1%), diarrhea (69.0%), conjunctival hemorrhage (31.0%), pulmonary edema (31.0%), pulmonary hemorrhage (13.8%), and transient encephalopathy (17.2%). Patient with pulmonary involvement were more likely to require dialysis but was not statistically significant. AKI was very common during leukocyte engraftment in AL patients. While infectious etiology accounted for some of the AKI, most appeared to be associated with ES. After infection is ruled out, ES should be considered in the differential diagnosis when evaluating AKI in this population. Am. J. Hematol. 87:51-54, 2012. V V C 2011 Wiley Periodicals, Inc. IntroductionEngraftment syndrome (ES) is a complication of hematopoietic stem cell transplantation that occurs around the time of neutrophil recovery. It is characterized by fever, rash, diarrhea, weight gain, and non-cardiogenic pulmonary edema within days of leukocyte engraftment [1][2][3]. Currently, no standard diagnostic criteria have been agreed upon. The two more commonly used are the Spitzer and Maiolino criteria. The Spitzer criteria regard non-infectious fever, erythrodermatous rash, and noncardiogenic pulmonary edema as major criteria and hepatic dysfunction, renal insufficiency, weight gain, and transient encephalopathy as minor criteria [4]. A diagnosis is made when all three major criteria or two major and at least one minor criterion are present. The Maiolino criteria only include pulmonary infiltrates, diarrhea, fever, and rash [5]. A diagnosis of ES is made when fever and one of the other three features are present.Acute kidney injury (AKI) has been recognized in ES and is not uncommon. A recent study found 26% of the patients diagnosed with ES by either Maiolino or Spitzer criteria had AKI [6]. Despite that, renal impairment as defined by twice the normal serum creatinine (Scr) was regarded as a minor criterion in one and completely excluded by the other [4,5]. This is interesting since even mild AKI...

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Section: Discussionmentioning

confidence: 98%

Section: Engraftment Syndromementioning

confidence: 99%

Acute kidney injury during leukocyte engraftment after autologous stem cell transplantation in patients with light‐chain amyloidosis

et al. 2011

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“…In addition, interstitial pneumonia related to the use of G-CSF has occasionally reported [1,12,23]. It has been postulated that G-CSF exacerbates underlying subclinical pulmonary toxicity induced by chemotherapy by augmenting leukocyte production, pulmonary sequestration, and migration [10]. Therefore, G-CSF may have augmented the pulmonary toxicity of this combination regimen, too.…”

Section: Discussionmentioning

confidence: 99%

Phase I trial of irinotecan and amrubicin with granulocyte colony-stimulating factor support in extensive-stage small-cell lung cancer

Asakuma

Yamamoto

Wada

et al. 2012

Cancer Chemother Pharmacol

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“…In AL, most patients are hematologically normal yet have significant organ dysfunction at the site of amyloid deposition: heart, liver, nerve, kidney, or lung. Patients may die of cardiac arrhythmias, 8 fatal pulmonary toxicity, 36 intractable cardiac failure, 7 gastrointestinal tract bleeding, 37 or precipitous renal failure, 15 which is rarely if ever seen in multiple myeloma. The decision to treat a patient with AL by transplantation must be undertaken with extreme caution, and ultimately a phase 3 trial to assess transplantation will be necessary, so the mistakes of transplantation for breast cancer are not repeated.…”

Section: Discussionmentioning

confidence: 99%

A multicenter phase 2 trial of stem cell transplantation for immunoglobulin light-chain amyloidosis (E4A97): an Eastern Cooperative Oncology Group Study

Gertz

Blood

Vesole

et al. 2004

Bone Marrow Transplant

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Summary:Stem cell transplantation was introduced as a new therapeutic modality for amyloidosis. The purpose of the current study was to determine the feasibility and toxicity of stem cell transplantation for amyloidosis in a cooperative group setting in which most participating institutions would have limited experience in managing the disorder. A total of 30 patients with biopsy-proven amyloidosis shown to be immunoglobulin light-chain type were enrolled on this trial. The protocol required mobilization of a minimum of 6 Â 10 8 mononuclear cells/ kg or 5 Â 10 6 CD34 þ cells/kg ideal body weight. These targets had to be achieved within seven collections. Patients with advanced hepatic, renal, or cardiac failure were excluded. End points included objective response rate and overall survival. The secondary end point of the protocol was nonhematologic toxicity. Accrual to the study was faster than expected. The overall response rate (hematologic and organ) was 64%, with three treatmentrelated deaths. Another patient died before day 30 of sudden cardiac death not treatment related. The median follow-up of surviving patients is 30.3 months. Median survival has not been reached. Stem cell transplantation for selected patients with amyloidosis is feasible in a cooperative group setting. A multicenter phase 3 trial of high-dose therapy is indicated.

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Fatal Pulmonary Toxicity Related to the Administration of Granulocyte Colony-Stimulating Factor in Amyloidosis: A Report and Review of Growth Factor-Induced Pulmonary Toxicity

Cited by 38 publications

References 42 publications

Acute kidney injury during leukocyte engraftment after autologous stem cell transplantation in patients with light‐chain amyloidosis

Acute kidney injury during leukocyte engraftment after autologous stem cell transplantation in patients with light‐chain amyloidosis

Phase I trial of irinotecan and amrubicin with granulocyte colony-stimulating factor support in extensive-stage small-cell lung cancer

A multicenter phase 2 trial of stem cell transplantation for immunoglobulin light-chain amyloidosis (E4A97): an Eastern Cooperative Oncology Group Study

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