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Case Reports
. 2019 Feb 13:2019:8174986.
doi: 10.1155/2019/8174986. eCollection 2019.

Granulocyte Colony Stimulating Factor (G-CSF) Induced Splenic Infarction in Breast Cancer Patient Treated with Dose-Dense Chemotherapy Regimen

Majed A Alshamrani  1   2 , Meteb Al-Foheidi  2   3 , Ahmed H Abdulrahim  2   3
Affiliations
Case Reports

Granulocyte Colony Stimulating Factor (G-CSF) Induced Splenic Infarction in Breast Cancer Patient Treated with Dose-Dense Chemotherapy Regimen

Majed A Alshamrani et al. Case Rep Oncol Med. .

Abstract

Introduction: Granulocyte colony-stimulating factor (G-CSF) is commonly used for prevention and treatment of febrile neutropenia among solid tumor patients. It is considered an effective and relatively safe supportive care medication; however, it can cause rare and serious side effects such as spleen rupture or infarction.

Case presentation: We are reporting a case of a 27-year-old female with breast cancer who has been treated with dose-dense chemotherapy and received colony-stimulating factor as primary prevention of febrile neutropenia that was complicated halfway through with splenic infarction. This finding was confirmed by computed tomography (CT) scan and splenic biopsy. Management was conservative without the need of surgical intervention.

Conclusion: Although splenic infarction is an extremely rare side effect of G-CSF, it can be a serious complication that should be recognized, monitored, and managed carefully.

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Figures

Figure 1
Figure 1
Baseline CT scan shows the normal size and appearance of the spleen before using granulocyte colony-stimulating factor (G-CSF).
Figure 2
Figure 2
Hepatosplenomegaly with multiple splenic hypodensities consistent with splenic infarction (arrow) after using G-CSF.
Figure 3
Figure 3
Splenic tissue with focal hemorrhagic infarction necrosis and predominantly neutrophil polymorphs. (a–d) H/E-stained section.
Figure 4
Figure 4
Follow-up CT scan shows hepatosplenomegaly with interval improvement regarding the splenic infarction.
See this image and copyright information in PMC

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