Capillary leak syndrome during low dose granulocyte-macrophage colony-stimulating factor (rh GM-CSF) treatment of a patient in a continuous febrile state.

Abstract

A 20 years old man with peripheral primitive neuroectodermal tumor involving the bone marrow received 12 Gy fractionated total body irradiation, 140 mg/m2 melphalan, 1800 mg/m2 etoposide, and 1500 mg/m2 carboplatin for consolidation of first remission. Thereafter, 250 micrograms/m2/day recombinant human granulocyte-macrophage colony-stimulating factor (rh GM-CSF) (Behring Werke) were administered as continuous infusion 4 days after infusion of autologous bone marrow and peripheral stem cells to accelerate granulocyte reconstitution for control of a continued febrile state. The clinical picture of capillary leak syndrome developed with weight gain, pleural effusions and peripheral edema. The patient's condition stabilized after discontinuation of rh GM-CSF. Eight days later he died of invasive aspergillosis. The clinical course of our patient suggests a potentially fatal toxic effect of rh GM-CSF, even in low dose, in the setting of septicemia or fungemia.

• Authors: W Emminger, W Emminger-Schmidmeier, C Peters, M Susani, R Hawliczek, P Höcker, H Gadner
• Journal: Blut (Blut) Vol. 61 Issue 4 Pg. 219-21 (Oct 1990) ISSN: 0006-5242 [Print] Germany
• PMID: 2224143 (Publication Type: Journal Article)

Chemical References

• Recombinant Proteins
• Granulocyte-Macrophage Colony-Stimulating Factor

Topics

• Adult
• Capillary Permeability (physiology)
• Fever (drug therapy)
• Granulocyte-Macrophage Colony-Stimulating Factor (administration & dosage, therapeutic use)
• Humans
• Male
• Recombinant Proteins (administration & dosage, therapeutic use)
• Shock (blood, chemically induced)