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Severe hypersensitivity allergic reaction to filgrastim in a healthy stem cell donor

Introduction Granulocyte–colony stimulating factor (G-CSF) has been approved for use for mobilization of hematopoietic progenitor cells from the marrow into the blood for peripheral blood stem cell collection. Commonly reported side effects of G-CSF include deep throbbing bone pain, severe myalgia a...

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Published in:Journal of oncology pharmacy practice 2019-12, Vol.25 (8), p.2056-2058
Main Authors: Doval, Divya, Choudhary, Dharma, Sharma, Sanjeev K, Khandelwal, Vipin
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Choudhary, Dharma
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description Introduction Granulocyte–colony stimulating factor (G-CSF) has been approved for use for mobilization of hematopoietic progenitor cells from the marrow into the blood for peripheral blood stem cell collection. Commonly reported side effects of G-CSF include deep throbbing bone pain, severe myalgia and leucocytosis. Case report We describe a case of severe hypersensitivity anaphylactoid reaction after filgrastim administration in a healthy stem cell donor. This haploidentical donor was a 38-year old man with sickle cell trait, donating stem cells for his son, a case of sickle cell disease. On administration of G-CSF (10 µg/kg) he developed features of anaphylaxis. Management and outcome He was given supportive care with oxygen, IV fluid bolus, anti histaminics and steroids. The donor had complete recovery and underwent successful bone marrow harvest. Conclusion There have been various reports of hypersensitivity anaphylactoid reactions in patients undergoing chemotherapy but those associated with the first dose of G-CSF in healthy stem cell donors have rarely been reported.
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Commonly reported side effects of G-CSF include deep throbbing bone pain, severe myalgia and leucocytosis. Case report We describe a case of severe hypersensitivity anaphylactoid reaction after filgrastim administration in a healthy stem cell donor. This haploidentical donor was a 38-year old man with sickle cell trait, donating stem cells for his son, a case of sickle cell disease. On administration of G-CSF (10 µg/kg) he developed features of anaphylaxis. Management and outcome He was given supportive care with oxygen, IV fluid bolus, anti histaminics and steroids. The donor had complete recovery and underwent successful bone marrow harvest. Conclusion There have been various reports of hypersensitivity anaphylactoid reactions in patients undergoing chemotherapy but those associated with the first dose of G-CSF in healthy stem cell donors have rarely been reported.</description><identifier>ISSN: 1078-1552</identifier><identifier>EISSN: 1477-092X</identifier><identifier>DOI: 10.1177/1078155219856419</identifier><identifier>PMID: 31203715</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Anaphylactoid reactions ; Anaphylaxis ; Bone marrow ; Bone marrow transplantation ; Chemotherapy ; Colony-stimulating factor ; Drug Hypersensitivity - etiology ; Filgrastim - administration &amp; dosage ; Filgrastim - adverse effects ; Granulocyte colony-stimulating factor ; Hematopoietic Stem Cell Mobilization ; Hematopoietic stem cells ; Hematopoietic Stem Cells - cytology ; Humans ; Hypersensitivity ; Leukocytes (granulocytic) ; Male ; Myalgia ; Pain - chemically induced ; Peripheral blood ; Progenitor cells ; Sickle cell disease ; Stem cell transplantation ; Stem cells ; Steroid hormones ; Steroids ; Tissue Donors</subject><ispartof>Journal of oncology pharmacy practice, 2019-12, Vol.25 (8), p.2056-2058</ispartof><rights>The Author(s) 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-5e08b20ed20ead6db712ff6de611f98452aeb5130b2f3bb61c87b1c3c127e6083</citedby><cites>FETCH-LOGICAL-c365t-5e08b20ed20ead6db712ff6de611f98452aeb5130b2f3bb61c87b1c3c127e6083</cites><orcidid>0000-0002-3511-0977</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27898,27899</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31203715$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Doval, Divya</creatorcontrib><creatorcontrib>Choudhary, Dharma</creatorcontrib><creatorcontrib>Sharma, Sanjeev K</creatorcontrib><creatorcontrib>Khandelwal, Vipin</creatorcontrib><title>Severe hypersensitivity allergic reaction to filgrastim in a healthy stem cell donor</title><title>Journal of oncology pharmacy practice</title><addtitle>J Oncol Pharm Pract</addtitle><description>Introduction Granulocyte–colony stimulating factor (G-CSF) has been approved for use for mobilization of hematopoietic progenitor cells from the marrow into the blood for peripheral blood stem cell collection. Commonly reported side effects of G-CSF include deep throbbing bone pain, severe myalgia and leucocytosis. Case report We describe a case of severe hypersensitivity anaphylactoid reaction after filgrastim administration in a healthy stem cell donor. This haploidentical donor was a 38-year old man with sickle cell trait, donating stem cells for his son, a case of sickle cell disease. On administration of G-CSF (10 µg/kg) he developed features of anaphylaxis. Management and outcome He was given supportive care with oxygen, IV fluid bolus, anti histaminics and steroids. The donor had complete recovery and underwent successful bone marrow harvest. 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Commonly reported side effects of G-CSF include deep throbbing bone pain, severe myalgia and leucocytosis. Case report We describe a case of severe hypersensitivity anaphylactoid reaction after filgrastim administration in a healthy stem cell donor. This haploidentical donor was a 38-year old man with sickle cell trait, donating stem cells for his son, a case of sickle cell disease. On administration of G-CSF (10 µg/kg) he developed features of anaphylaxis. Management and outcome He was given supportive care with oxygen, IV fluid bolus, anti histaminics and steroids. The donor had complete recovery and underwent successful bone marrow harvest. 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subjects Adult
Anaphylactoid reactions
Anaphylaxis
Bone marrow
Bone marrow transplantation
Chemotherapy
Colony-stimulating factor
Drug Hypersensitivity - etiology
Filgrastim - administration & dosage
Filgrastim - adverse effects
Granulocyte colony-stimulating factor
Hematopoietic Stem Cell Mobilization
Hematopoietic stem cells
Hematopoietic Stem Cells - cytology
Humans
Hypersensitivity
Leukocytes (granulocytic)
Male
Myalgia
Pain - chemically induced
Peripheral blood
Progenitor cells
Sickle cell disease
Stem cell transplantation
Stem cells
Steroid hormones
Steroids
Tissue Donors
title Severe hypersensitivity allergic reaction to filgrastim in a healthy stem cell donor
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