An 85-year-old man experienced
leukopenia likely due to
colchicine. His medical history included
chronic lymphocytic leukemia (CLL),
pseudogout,
osteoarthritis, and
hypertension. In February 2011, his white blood cell (WBC) count was 2700 cells/μL, and his absolute neutrophil count (ANC) was 2200 cells/μL.
Colchicine 0.6 mg orally daily was initiated in March for the prophylaxis of
pseudogout. His WBC count decreased, and his
colchicine dosage was reduced to 0.6 mg every other day. Despite this decreased dosage, his WBC count and ANC were 600 and 100 cells/μL, respectively, in September. In October, the patient received
chemotherapy for presumed worsening of his CLL. One month later, his WBC count and ANC were 400 and 200 cells/μL, respectively. Subcutaneous
filgrastim was administered, and
colchicine was discontinued. At the end of November, he received another cycle of
chemotherapy followed by
pegfilgrastim. On the day of
pegfilgrastim administration, the patient's WBC count and ANC were 2000 and 1300 cells/μL, respectively. Two weeks later, his WBC count was 8800 cells/μL, and his ANC was 8300 cells/μL. Daily
colchicine was restarted at the end of December. Two months later, his WBC count and ANC were 800 and 500 cells/μL, respectively. Given the symptomatic relief with
colchicine,
therapy was continued with close monitoring.
CONCLUSION: