An IL-6 inhibitor subsides iatrogenic aortitis induced by granulocyte colony-stimulating factor without interruption of chemotherapy.

Abstract

Recombinant human granulocyte-colony stimulating factor (G-CSF) is widely used for primary or secondary leukopenia induced by chemotherapy with strong anticancer drugs. Recently, there have been rare but accumulating cases of aortitis in patients receiving G-CSF agents, which is usually treated with glucocorticoids. Here, we report a case of G-CSF-induced aortitis complicated with intensive chemotherapy for Ewing's sarcoma, who was successfully treated with one bolus of intravenous tocilizumab, an anti-interleukin IL-6 inhibitor, resulting in early suppression of aortic inflammation and prompt resume of chemotherapy. Our current case provides useful insights into the pathogenesis of G-CSF-induced aortitis and its treatment strategy with an IL-6 blockade without glucocorticoids.