A case of G-CSF-producing lung cancer presenting with severe bone marrow suppression during chemotherapy
Sahoko Imoto Ryosuke Satomi Sakiko Hosoo Kazuma Yagi Mayuko Koshibe Yoshitaka Oyamada
Department of Respiratory Medicine, National Hospital Organization Tokyo Medical Center
This case concerns a 60-year-old man, diagnosed with primary lung adenocarcinoma (cT1bN3M1b cStage IV). His laboratory data revealed leukocytosis and thrombocytosis. Serum granulocyte colony-stimulating factor (G-CSF) levels were elevated, and in addition immunohistochemical staining using anti-G-CSF monoclonal antibody revealed tumor cells containing G-CSF, leading us to conclude that the tumor was producing the G-CSF. We started first-line chemotherapy (cisplatin and pemetrexed). Severe bone marrow suppression (grade 4 leukopenia and neutropenia, grade 3 anemia, and grade 2 thrombocytopenia) occurred, accompanied by life-threatening pneumonia. To our knowledge, there are no reports of chemotherapy-induced severe bone marrow suppression in cases of G-CSF-producing cancer. More case examples are needed to determine treatment measures for such cases.
Granulocyte-colony stimulating factor (G-CSF) G-CSF producing carcinoma Lung cancer Chemotherapy Bone marrow suppression
Received 1 Aug 2017 / Accepted 26 Sep 2017
AJRS, 7(1): 10-14, 2018