Abstract
Objective
To examine the impact of granulocyte-colony stimulating factor (G-CSF) use on the
incidence and severity of bleomycin-induced pneumonitis (BIP) in patients with germ
cell tumor (GCT) receiving first-line chemotherapy.
Patients and Methods
Clinical data from our institutional GCT database was complemented by review of radiology,
pharmacy, and medical records. All patients receiving first line chemotherapy between
January 1, 2000 and December 31, 2010 were included. Patients receiving at least 1
dose of G-CSF were identified. BIP was graded using Common Terminology Criteria for
Adverse Events criteria. Logistic regression was used to explore predictors for risk
and severity of BIP. Statistical significance was defined as P < .05.
Results
Data on 212 patients with GCT treated with a bleomycin-containing chemotherapy regimen
were available. The median age was 31 years. The median follow-up period was 36.7
months. BIP occurred in 73 patients (34%), a majority (n = 55) of which were asymptomatic
events (Common Terminology Criteria for Adverse Events, grade 1). G-CSF use was not
associated with increased risk of BIP in multivariable analyses (odds ratio, 1.60;
P = .13), nor was it associated with increased severity of symptomatic BIP (on average
1.22 grades higher; P = .09). There was a non-statistically significant trend towards greater risk of BIP
in patients that developed renal impairment during chemotherapy treatment (odds ratio,
2.56; P = .053).
Conclusion
In patients with GCT receiving first line chemotherapy, G-CSF use is not associated
with an increased risk of BIP. Furthermore, the use of G-CSF did not have any significant
effect on the severity of BIP events. Clinicians are reminded to be vigilant of patients
that develop renal impairment while undergoing chemotherapy treatment, given the greater
risk of BIP.
Keywords
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Article Info
Publication History
Published online: September 04, 2017
Accepted:
August 28,
2017
Received in revised form:
August 27,
2017
Received:
May 15,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
