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

J Oncol Pharm Pract. 2019 Dec;25(8):2056-2058. doi: 10.1177/1078155219856419. Epub 2019 Jun 15.

Abstract

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.

Keywords: Anaphylactoid; G-CSF; donor; hypersensitivity; sickle cell trait.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Drug Hypersensitivity / etiology*
  • Filgrastim / administration & dosage
  • Filgrastim / adverse effects*
  • Hematopoietic Stem Cell Mobilization
  • Hematopoietic Stem Cells / cytology
  • Humans
  • Male
  • Pain / chemically induced
  • Tissue Donors*

Substances

  • Filgrastim