Anaphylaxis from filgrastim prophylaxis within the same day of chemotherapy: A case report

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Abstract

Introduction

Filgrastim is recommended to be used 24–72 h after the last dose of chemotherapy for the prophylaxis of febrile neutropenia. However, several studies demonstrate the efficacy and safety of the use of filgrastim within the same day of the last dose of chemotherapy.

Case presentation

We presented a patient with state IIIC immature teratoma at her right ovary who was treated with the BEP regimen. She received 10 doses of filgrastim per BEP cycle to prevent febrile neutropenia. On the first BEP cycle, the first dose of filgrastim was used within 24 h after the last chemotherapy dose and dyspnea was developed. On the second cycle of BEP, filgrastim was still used as the same-day regimen. One hour after the first dose of filgrastim, anaphylaxis occurred and the patient was treated appropriately. The second dose of filgrastim can be rechallenged successfully and filgrastim can be finished without any adverse events. On the third and fourth cycles of BEP, filgrastim was used as the next-day regimen (interval longer than 24 h). There were no adverse events that occurred during the use of filgrastim.

Conclusion

The residual chemotherapy may increase the risk of anaphylaxis induced by filgrastim via a non-IgE-mediated mechanism in this case patient.
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化疗当天服用非格司亭预防药物引发过敏性休克:病例报告
导言:为预防发热性中性粒细胞减少症,建议在最后一次化疗后24-72小时使用非格司亭。我们接诊了一名右卵巢IIIC级未成熟畸胎瘤患者,她接受了BEP方案治疗。为了预防发热性中性粒细胞减少症,她在每个BEP周期接受了10剂filgrastim治疗。在第一个 BEP 周期,第一剂菲格拉司汀是在最后一次化疗用药后 24 小时内使用的,结果出现了呼吸困难。在第二周期的BEP治疗中,菲格司汀仍作为当天的治疗方案使用。第一次使用非格司亭一小时后,过敏性休克发生,患者接受了适当治疗。第二剂菲格拉司汀可成功再注射,菲格拉司汀可在无任何不良反应的情况下用完。在第三和第四个 BEP 周期中,菲格司汀被用作次日用药(间隔时间超过 24 小时)。结论在本例患者中,残余化疗可能会通过非IgE介导的机制增加非格司亭诱发过敏性休克的风险。
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来源期刊
CiteScore
0.40
自引率
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审稿时长
96 days
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