Filgrastim-induced rhabdomyolysis in a healthy stem cells donor

Abstract

Introduction: Mobilization of peripheral blood progenitor cells with the use of granulocyte-colony stimulating factors is a mainstay in every protocol for allogenic stem cell transplants. Despite being considered safe, there are multiple adverse effects for this procedure some of which can be severe and bring serious complications to otherwise healthy donors. Case report: An otherwise healthy 17-year-old patient who underwent progenitor cell mobilization with filgrastim and developed rhabdomyolysis and acute kidney injury. Management and outcome: The urine analysis and kidney ultrasound failed to reveal abnormalities in the kidneys or collector system. We began reanimation with crystalloid solutions for 5 days with normalization of liver and muscle enzymes as well as a complete resolution of the acute kidney injury. Discussion: We present the case of a potentially serious adverse drug reaction during mobilization of peripheral blood progenitor cells with filgrastim. Physicians need to be aware of every possible complication associated with the use of these agents in order to establish a good prognosis via an accurate diagnosis and a timely treatment.