While the granulocyte colony stimulating factors (G-CSF) filgrastim (Neupogen<sup>®</sup>), pegfilgrastim (Neulasta<sup>®</sup>), and sargramostim (Leukine<sup>®</sup>) are approved to increase survival in patients exposed to a myelosuppressive dose of radiation, no medical countermeasure is currently available for treatment of the thrombocytopenia that also results following radiation exposure.
While mild thrombocytopenia is common in allogeneic peripheral blood stem cell transplant donors after G-CSF mobilization, serious thrombocytopenia is rarely reported.
Collectively, G-CSF administration can result in thrombocytopenia in hematopoietic stem cell donors and exacerbate existing thrombocytopenia in transplantation recipients.
Her clinical course was complicated by the development of neutropenia, requiring granulocyte colony-stimulating factor, and thrombocytopenia, requiring intermittent platelet transfusions, with later development of B acute lymphoblastic leukemia 2 years after initial presentation.
Grade 3/4 neutropenia was seen in 15 (35%) patients, nine (21%) required prophylactic granulocyte colony-stimulating factor, 13 (30%) patients had grade 3/4 thrombocytopenia.
High-dose paclitaxel with granulocyte colony-stimulating factor in patients with advanced breast cancer refractory to anthracycline therapy: a European Cancer Center trial.