Literature review analysis of aortitis induced by granulocyte-colony stimulating factor

Abstract

Background: Recombinant human granulocyte-colony stimulating factors (G-CSF)-induced aortitis is a rare but particularly serious adverse event, commonly seen in cancer patients undergoing chemotherapy. The aim of this article is to clarify the clinical characteristics of G-CSF- induced aortitis and provide effective references for clinical diagnosis and intervention.

Methods: Case reports of adverse reactions of aortitis induced by G-CSF were collected from the relevant databases. The patients' basic information and adverse reaction process were recorded and subjected to descriptive analysis.

Results: A total of 72 patients were enrolled, including 14 males and 58 females, with a mean age of 61.83 ± 10.30 years. The G-CSF type with the highest frequency of occurrence of aortitis is pegfilgrastim. Apart from three healthy stem cell donors, G-CSF-induced aortitis was primarily found in patients with underlying malignancies, especially in patients with breast cancer. The most common anticancer drugs used at onset were docetaxel, cyclophosphamide, and doxorubicin. CT scan showed that aortitis most commonly occured in the aortic arch and its branches. Most patients had a good prognosis, but 3 cases developed complications. Importantly, G-CSF-induced aortitis was also found in 4 asymptomatic patients.

Conclusion: This article found that G-CSF-induced aortitis not only occured in cancer patients undergoing chemotherapy as previously reported in literature, but also in healthy stem cell donors. Especially, asymptomatic patients with G-CSF-induced aortitis faced a greater risk of being missed by the attending physician.

Keywords: adverse event; aortitis; cancer; chemotherapy; recombinant human granulocyte-colony stimulating factor.

FIGURE 1

The annual trends in the number of G-CSF administrations.

FIGURE 2

The distribution of G-CSF-induced aortitis in countries around the world.

FIGURE 3

Graph shows cancer types among patients with G-CSF-induced aortitis.

FIGURE 4

Graph shows the frequency of primary aortitis in patients with different chemotherapy regimen.

FIGURE 5

Graph shows distribution of G-CSF-induced aortitis at CT. Vertical axis indicates location of the aorta and its branches, and abscissa indicates the number of patients with G-CSF-induced aortitis. BCA = brachiocephalic artery; CCA = common carotid artery; SCA = subclavian artery.