Background: There are several case reports suggesting that G-CSFs may, in rare conditions, produce serious side effects, such as vasculitis. Materials & methods: A systematic search was conducted in Medline via PubMed, Embase and Cochrane Library to describe this unusual side effect to raise awareness among clinicians for early recognition and treatment. Results: Fifty-seven patients were analyzed. The most prevalent cancer type was breast cancer (47%). Long-acting G-CSF was used in 38 patients (67%). Only 47% of patients were treated with steroids. Conclusion: Although the benefit of G-CSF treatment outweighs the potential damage, oncologists should consider the possibility of triggering a vascular toxicity and try to identify patients at increased risk for this side effect.
Keywords: G-CSF; G-CSF-related vasculitis; IL-6; antineutrophil cytoplasmic antibodies; neutropenia recovery; neutrophil; review; side effect.
Lay abstract Background: Several case reports suggest that a type of drug called granulocyte colony-stimulating factor (G-CSFs) may, in rare cases, produce serious side effects, such as vasculitis. Materials & methods: A systematic search was conducted to describe this unusual side effect. Results: Fifty-seven patients were analyzed. The most prevalent cancer type in which this side effect was observed was breast cancer (47%). Only 47% of patients were treated with steroids. The main symptoms, such as fever, chest/epigastric pain and general malaise, are nonspecific and cannot be used to diagnose the side effect; laboratory findings are suggestive of inflammation. Conclusion: Accurate assessment of what causes this adverse event is extremely important. Although the benefit of G-CSF treatment outweighs the potential damage, oncologists should consider the possibility of triggering vascular toxicity and try to identify patients at increased risk.