Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1994 Nov;70(5):1009–1013. doi: 10.1038/bjc.1994.439

Serious pulmonary complications in patients receiving recombinant granulocyte colony-stimulating factor during BACOP chemotherapy for aggressive non-Hodgkin's lymphoma.

K I Lei 1, W T Leung 1, P J Johnson 1
PMCID: PMC2033539  PMID: 7524599

Abstract

Four of 12 Chinese patients receiving BACOP, in combination with recombinant human granulocyte colony-stimulating factor, for aggressive non-Hodgkin's lymphoma developed a rapidly progressive pneumonic illness characterised by diffuse pulmonary infiltrates and hypoxaemia. The condition proved fatal in three, and in none could an infective cause be identified. A retrospective analysis revealed only one episode of pneumonia in the previous 24 patients in whom the same BACOP regimen was administered without granulocyte colony-stimulating factor support. Granulocyte colony-stimulating factor, by augmenting white cell production, pulmonary sequestration and margination and production of toxic oxygen species, may exacerbate underlying subclinical bleomycin pulmonary toxicity. Caution should be exercised before using granulocyte-stimulating factors in bleomycin-containing regimens.

Full text

PDF
1012

Images in this article

1011Figure 1
on p.1011
1011Figure 2
on p.1011
1011Figure 3
on p.1011

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bauer K. A., Skarin A. T., Balikian J. P., Garnick M. B., Rosenthal D. S., Canellos G. P. Pulmonary complications associated with combination chemotherapy programs containing bleomycin. Am J Med. 1983 Apr;74(4):557–563. doi: 10.1016/0002-9343(83)91009-4. [DOI] [PubMed] [Google Scholar]
  2. Bronchud M. H., Potter M. R., Morgenstern G., Blasco M. J., Scarffe J. H., Thatcher N., Crowther D., Souza L. M., Alton N. K., Testa N. G. In vitro and in vivo analysis of the effects of recombinant human granulocyte colony-stimulating factor in patients. Br J Cancer. 1988 Jul;58(1):64–69. doi: 10.1038/bjc.1988.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bronchud M. H., Scarffe J. H., Thatcher N., Crowther D., Souza L. M., Alton N. K., Testa N. G., Dexter T. M. Phase I/II study of recombinant human granulocyte colony-stimulating factor in patients receiving intensive chemotherapy for small cell lung cancer. Br J Cancer. 1987 Dec;56(6):809–813. doi: 10.1038/bjc.1987.295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gabrilove J. L., Jakubowski A., Fain K., Grous J., Scher H., Sternberg C., Yagoda A., Clarkson B., Bonilla M. A., Oettgen H. F. Phase I study of granulocyte colony-stimulating factor in patients with transitional cell carcinoma of the urothelium. J Clin Invest. 1988 Oct;82(4):1454–1461. doi: 10.1172/JCI113751. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gabrilove J. L., Jakubowski A., Scher H., Sternberg C., Wong G., Grous J., Yagoda A., Fain K., Moore M. A., Clarkson B. Effect of granulocyte colony-stimulating factor on neutropenia and associated morbidity due to chemotherapy for transitional-cell carcinoma of the urothelium. N Engl J Med. 1988 Jun 2;318(22):1414–1422. doi: 10.1056/NEJM198806023182202. [DOI] [PubMed] [Google Scholar]
  6. Ginsberg S. J., Crooke S. T., Bloomfield C. D., Peterson B., Kennedy B. J., Blom J., Ellison R. R., Pajak T. F., Gottlieb A. J. Cyclophosphamide, doxorubicin, vincristine, and low-dose continuous infusion bleomycin in non-Hodgkin's lymphoma: Cancer and Leukemia Group B Study No. 7804. Cancer. 1982 Apr 1;49(7):1346–1352. doi: 10.1002/1097-0142(19820401)49:7<1346::aid-cncr2820490706>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  7. Gordon L. I., Harrington D., Andersen J., Colgan J., Glick J., Neiman R., Mann R., Resnick G. D., Barcos M., Gottlieb A. Comparison of a second-generation combination chemotherapeutic regimen (m-BACOD) with a standard regimen (CHOP) for advanced diffuse non-Hodgkin's lymphoma. N Engl J Med. 1992 Nov 5;327(19):1342–1349. doi: 10.1056/NEJM199211053271903. [DOI] [PubMed] [Google Scholar]
  8. Iki S., Yoshinaga K., Ohbayashi Y., Urabe A. Cytotoxic drug-induced pneumonia and possible augmentation by G-CSF--clinical attention. Ann Hematol. 1993 Apr;66(4):217–218. doi: 10.1007/BF01703240. [DOI] [PubMed] [Google Scholar]
  9. Kreisman H., Wolkove N. Pulmonary toxicity of antineoplastic therapy. Semin Oncol. 1992 Oct;19(5):508–520. [PubMed] [Google Scholar]
  10. Lindemann A., Herrmann F., Oster W., Haffner G., Meyenburg W., Souza L. M., Mertelsmann R. Hematologic effects of recombinant human granulocyte colony-stimulating factor in patients with malignancy. Blood. 1989 Dec;74(8):2644–2651. [PubMed] [Google Scholar]
  11. Matthews J. H. Pulmonary toxicity of ABVD chemotherapy and G-CSF in Hodgkin's disease: possible synergy. Lancet. 1993 Oct 16;342(8877):988–988. doi: 10.1016/0140-6736(93)92033-p. [DOI] [PubMed] [Google Scholar]
  12. Morstyn G., Campbell L., Souza L. M., Alton N. K., Keech J., Green M., Sheridan W., Metcalf D., Fox R. Effect of granulocyte colony stimulating factor on neutropenia induced by cytotoxic chemotherapy. Lancet. 1988 Mar 26;1(8587):667–672. doi: 10.1016/s0140-6736(88)91475-4. [DOI] [PubMed] [Google Scholar]
  13. Morstyn G., Lieschke G. J., Sheridan W., Layton J., Cebon J. Pharmacology of the colony-stimulating factors. Trends Pharmacol Sci. 1989 Apr;10(4):154–159. doi: 10.1016/0165-6147(89)90168-5. [DOI] [PubMed] [Google Scholar]
  14. Neidhart J., Mangalik A., Kohler W., Stidley C., Saiki J., Duncan P., Souza L., Downing M. Granulocyte colony-stimulating factor stimulates recovery of granulocytes in patients receiving dose-intensive chemotherapy without bone marrow transplantation. J Clin Oncol. 1989 Nov;7(11):1685–1692. doi: 10.1200/JCO.1989.7.11.1685. [DOI] [PubMed] [Google Scholar]
  15. Ohsaka A., Kitagawa S., Sakamoto S., Miura Y., Takanashi N., Takaku F., Saito M. In vivo activation of human neutrophil functions by administration of recombinant human granulocyte colony-stimulating factor in patients with malignant lymphoma. Blood. 1989 Dec;74(8):2743–2748. [PubMed] [Google Scholar]
  16. Pettengell R., Gurney H., Radford J. A., Deakin D. P., James R., Wilkinson P. M., Kane K., Bentley J., Crowther D. Granulocyte colony-stimulating factor to prevent dose-limiting neutropenia in non-Hodgkin's lymphoma: a randomized controlled trial. Blood. 1992 Sep 15;80(6):1430–1436. [PubMed] [Google Scholar]
  17. Pizzo P. A. Granulocytopenia and cancer therapy. Past problems, current solutions, future challenges. Cancer. 1984 Dec 1;54(11 Suppl):2649–2661. doi: 10.1002/1097-0142(19841201)54:2+<2649::aid-cncr2820541409>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  18. Shapiro C. L., Yeap B. Y., Godleski J., Jochelson M. S., Shipp M. A., Skarin A. T., Canellos G. P. Drug-related pulmonary toxicity in non-Hodgkin's lymphoma. Comparative results with three different treatment regimens. Cancer. 1991 Aug 15;68(4):699–705. doi: 10.1002/1097-0142(19910815)68:4<699::aid-cncr2820680406>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  19. Sheridan W. P., Morstyn G., Wolf M., Dodds A., Lusk J., Maher D., Layton J. E., Green M. D., Souza L., Fox R. M. Granulocyte colony-stimulating factor and neutrophil recovery after high-dose chemotherapy and autologous bone marrow transplantation. Lancet. 1989 Oct 14;2(8668):891–895. doi: 10.1016/s0140-6736(89)91552-3. [DOI] [PubMed] [Google Scholar]
  20. Skarin A. T., Rosenthal D. S., Moloney W. C., Frei E., 3rd Combination chemotherapy of advanced non-Hodgkin lymphoma with bleomycin, adriamycin, cyclophosphamide, vincristine, and prednisone (BACOP). Blood. 1977 May;49(5):759–770. [PubMed] [Google Scholar]
  21. Tanimura M., Kobuchi H., Utsumi T., Yoshioka T., Kataoka S., Fujita Y., Utsumi K. Neutrophil priming by granulocyte colony stimulating factor and its modulation by protein kinase inhibitors. Biochem Pharmacol. 1992 Sep 25;44(6):1045–1052. doi: 10.1016/0006-2952(92)90366-q. [DOI] [PubMed] [Google Scholar]
  22. Yoshida T., Nakamura S., Ohtake S., Okafuji K., Kobayashi K., Kondo K., Kanno M., Matano S., Matsuda T., Kanai M. Effect of granulocyte colony-stimulating factor on neutropenia due to chemotherapy for non-Hodgkin's lymphoma. Cancer. 1990 Nov 1;66(9):1904–1909. doi: 10.1002/1097-0142(19901101)66:9<1904::aid-cncr2820660908>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES