Treating chemotherapy induced agranulocytosis with granulocyte colony-stimulating factors in a patient on clozapine

Venkata Kolli, Kevin Denton, Dileep Borra, Madhuri Pulluri, Ashish Sharma

Research output: Contribution to journalArticle

14 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)1674-1675
Number of pages2
JournalPsycho-Oncology
Volume22
Issue number7
DOIs
StatePublished - Jul 1 2013

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Agranulocytosis
Clozapine
Granulocyte Colony-Stimulating Factor
Drug Therapy
Schizophrenia
B-Cell Lymphoma
Leukocyte Count
Granulocytes
PubMed
Methotrexate
Psychotic Disorders
Cell Count

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 journalArticle

Kolli, Venkata ; Denton, Kevin ; Borra, Dileep ; Pulluri, Madhuri ; Sharma, Ashish. / Treating chemotherapy induced agranulocytosis with granulocyte colony-stimulating factors in a patient on clozapine. In: Psycho-Oncology. 2013 ; Vol. 22, No. 7. pp. 1674-1675.
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