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Treating chemotherapy induced agranulocytosis with granulocyte colony-stimulating factors in a patient on clozapine.
MedLine Citation:
PMID:  23059755     Owner:  NLM     Status:  Publisher    
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. Copyright © 2012 John Wiley & Sons, Ltd.
Venkata Kolli; Kevin Denton; Dileep Borra; Madhuri Pulluri; Ashish Sharma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-12
Journal Detail:
Title:  Psycho-oncology     Volume:  -     ISSN:  1099-1611     ISO Abbreviation:  Psychooncology     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214524     Medline TA:  Psychooncology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 John Wiley & Sons, Ltd.
Creighton-Nebraska Psychiatry Residency Program, Omaha, NE, USA.
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