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Pseudogout Attack after Pegfilgrastim Administration in Anaplastic Large Cell Lymphoma
Mayumi Hatayama1, Katsuya Ikuta1, Masatomo Ishioh1
1Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan.
Internal Medicine (Tokyo, Japan)
|February 14, 2018
Summary
Pegylated interferon (PEG-IFN) is linked to pseudogout attacks in lymphoma patients. Switching to filgrastim prevented these attacks, suggesting PEG-IFN may cause pseudogout.
Area of Science:
- Oncology
- Rheumatology
- Pharmacology
Background:
- Anaplastic large cell lymphoma (ALCL) patients undergoing salvage chemotherapy may receive granulocyte colony-stimulating factors (G-CSFs) to prevent neutropenia.
- Pegfilgrastim is a commonly used G-CSF formulation.
Observation:
- A 67-year-old man with relapsed ALCL experienced two pseudogout attacks during chemotherapy cycles involving pegfilgrastim.
- The patient did not experience a pseudogout attack when filgrastim was used instead of pegfilgrastim.
Findings:
- Serum G-CSF levels were markedly elevated only during pegfilgrastim administration.
- This suggests a strong correlation between pegfilgrastim use and the occurrence of pseudogout attacks.
Implications:
- Pseudogout should be considered a potential adverse effect of pegfilgrastim in cancer patients.
- This finding may inform clinical practice regarding G-CSF selection in patients with a history of crystal-induced arthritis.
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