Abstract
Background Clozapine is reserved for overcoming treatment resistance in schizophrenia. Malignancy is common in schizophrenia; however, there is limited evidence available on continuing clozapine with chemotherapy, with both having hematological adverse effects. Objective To report a case on the use of granulocyte colony-stimulating factor (G-CSF) in conjunction with clozapine and chemotherapy. Methods We searched PubMed for any available information on the use of granulocyte G-CSF with clozapine and chemotherapy. We report the case of a patient with schizophrenia who developed B-cell lymphoma and was treated with chemotherapy consisting of CHOP regimen, rituximab, and methotrexate. He was continued on clozapine and G-CSF. Results We did not find any reports on G-CSF use in conjunction with clozapine and chemotherapy. We found case reports and a case series on the use of G-CSF in clozapine rechallenge with clozapine-induced agranulocytosis with mixed results. In our patient on clozapine, the white blood cell counts reduced by chemotherapy, were successfully replenished with the use of filgrastim, a G-CSF. Conclusions With risks of psychosis relapse and exacerbation with discontinuing clozapine, the addition of G-CSF could be a useful aid in replenishing white cell counts lost to chemotherapy whilst continuing clozapine. However, further study is needed on this combination.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1674-1675 |
| Number of pages | 2 |
| Journal | Psycho-Oncology |
| Volume | 22 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2013 |
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All Science Journal Classification (ASJC) codes
- Oncology
- Psychiatry and Mental health
- Experimental and Cognitive Psychology
Cite this
Treating chemotherapy induced agranulocytosis with granulocyte colony-stimulating factors in a patient on clozapine. / Kolli, Venkata; Denton, Kevin; Borra, Dileep; Pulluri, Madhuri; Sharma, Ashish.
In: Psycho-Oncology, Vol. 22, No. 7, 01.07.2013, p. 1674-1675.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treating chemotherapy induced agranulocytosis with granulocyte colony-stimulating factors in a patient on clozapine
AU - Kolli, Venkata
AU - Denton, Kevin
AU - Borra, Dileep
AU - Pulluri, Madhuri
AU - Sharma, Ashish
PY - 2013/7/1
Y1 - 2013/7/1
N2 - Background Clozapine is reserved for overcoming treatment resistance in schizophrenia. Malignancy is common in schizophrenia; however, there is limited evidence available on continuing clozapine with chemotherapy, with both having hematological adverse effects. Objective To report a case on the use of granulocyte colony-stimulating factor (G-CSF) in conjunction with clozapine and chemotherapy. Methods We searched PubMed for any available information on the use of granulocyte G-CSF with clozapine and chemotherapy. We report the case of a patient with schizophrenia who developed B-cell lymphoma and was treated with chemotherapy consisting of CHOP regimen, rituximab, and methotrexate. He was continued on clozapine and G-CSF. Results We did not find any reports on G-CSF use in conjunction with clozapine and chemotherapy. We found case reports and a case series on the use of G-CSF in clozapine rechallenge with clozapine-induced agranulocytosis with mixed results. In our patient on clozapine, the white blood cell counts reduced by chemotherapy, were successfully replenished with the use of filgrastim, a G-CSF. Conclusions With risks of psychosis relapse and exacerbation with discontinuing clozapine, the addition of G-CSF could be a useful aid in replenishing white cell counts lost to chemotherapy whilst continuing clozapine. However, further study is needed on this combination.
AB - Background Clozapine is reserved for overcoming treatment resistance in schizophrenia. Malignancy is common in schizophrenia; however, there is limited evidence available on continuing clozapine with chemotherapy, with both having hematological adverse effects. Objective To report a case on the use of granulocyte colony-stimulating factor (G-CSF) in conjunction with clozapine and chemotherapy. Methods We searched PubMed for any available information on the use of granulocyte G-CSF with clozapine and chemotherapy. We report the case of a patient with schizophrenia who developed B-cell lymphoma and was treated with chemotherapy consisting of CHOP regimen, rituximab, and methotrexate. He was continued on clozapine and G-CSF. Results We did not find any reports on G-CSF use in conjunction with clozapine and chemotherapy. We found case reports and a case series on the use of G-CSF in clozapine rechallenge with clozapine-induced agranulocytosis with mixed results. In our patient on clozapine, the white blood cell counts reduced by chemotherapy, were successfully replenished with the use of filgrastim, a G-CSF. Conclusions With risks of psychosis relapse and exacerbation with discontinuing clozapine, the addition of G-CSF could be a useful aid in replenishing white cell counts lost to chemotherapy whilst continuing clozapine. However, further study is needed on this combination.
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U2 - 10.1002/pon.3209
DO - 10.1002/pon.3209
M3 - Article
VL - 22
SP - 1674
EP - 1675
JO - Psycho-Oncology
JF - Psycho-Oncology
SN - 1057-9249
IS - 7
ER -