Journal
INTERNATIONAL JOURNAL OF HEMATOLOGY
Volume 76, Issue 4, Pages 360-364Publisher
SPRINGER JAPAN KK
DOI: 10.1007/BF02982697
Keywords
AML (M7); bronchiolitis obliterans with organizing pneumonia; filgrastim; peripheral stem cell transplant; relapse; polyserositis; graft-versus-leukemia; graft-versus-host disease
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Filgrastim (granulocyte colony-stimulating factor) has recently been reported to successfully treat patients with leukemic relapse after allogeneic peripheral stem cell transplantation (PSCT). However, the majority of the-patients who responded also devloped graft-versus-host disease (GVHD). Polyserositis as a manifestation of GVHD is a rare phenomenon. We report the first case of polyserositis following the use of filgrastim to treat a patient with acute myelogenous leukemia (M7), who had relapsed after an initially successful allogeneic PSCT. The polyserositis manifested with effusions and was initially controlled with high doses of steroids and pericardial stripping; however, after a quiescent period the patient eventually developed bronchiolitis obliterans with organizing pneumonia that required additional immunosuppressive therapy. We review the literature on GVHD-associated polyserositis and offer potential explanations for its pathogenesis.
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