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Related Experiment Videos

Leukopenia associated with long-term colchicine administration.

Ashton E Beggs¹, David J Reeves, Nancy S Noel

¹Department ofPharmacy Practice, College of Pharmacy, Belmont University, Nashville, TN 37212, USA. ashton.beggs@belmont.edu

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists

|December 12, 2012

Summary

Colchicine use for pseudogout in an 85-year-old man with chronic lymphocytic leukemia (CLL) led to severe leukopenia. Treatment involved dose reduction, filgrastim, and discontinuation, followed by careful reintroduction of colchicine.

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Area of Science:

Hematology
Rheumatology
Pharmacology

Background:

Calcium pyrophosphate dihydrate (CPPD) deposition disease, or pseudogout, is a crystal-induced arthropathy.
Colchicine is a medication commonly used for the prophylaxis and treatment of gout and pseudogout.
Chronic lymphocytic leukemia (CLL) is a type of cancer affecting lymphocytes.

Observation:

An 85-year-old male patient with a history of CLL, pseudogout, osteoarthritis, and hypertension developed leukopenia.
The patient was receiving colchicine for pseudogout prophylaxis, and his white blood cell (WBC) and absolute neutrophil count (ANC) decreased significantly.
Despite colchicine dose reduction, leukopenia persisted, necessitating filgrastim administration and colchicine discontinuation.

Findings:

Colchicine administration was temporally associated with severe leukopenia in a patient with CLL.
The patient's WBC and ANC counts improved after colchicine discontinuation and administration of filgrastim and pegfilgrastim.
Reintroduction of colchicine led to a recurrence of leukopenia, indicating a likely drug-induced etiology.

Implications:

This case highlights a potential adverse effect of colchicine in patients with underlying hematological conditions like CLL.
Close monitoring of blood counts is crucial for patients with CLL receiving colchicine, especially for pseudogout.
The findings suggest a need for careful consideration of colchicine use and potential drug interactions in patients with compromised bone marrow function.