原发性骨髓增生异常相关中性粒细胞减少症患者在择期手术前使用 Filgrastim 预防感染:病例报告

Sonya Mannala, Emmett Harrison
{"title":"原发性骨髓增生异常相关中性粒细胞减少症患者在择期手术前使用 Filgrastim 预防感染:病例报告","authors":"Sonya Mannala, Emmett Harrison","doi":"10.33590/emjhematol/fcvq4758","DOIUrl":null,"url":null,"abstract":"Myelodysplastic syndromes are a group of disorders that affect the bone marrow, subsequently affecting the growth and relative abundance of blood-forming cells in the circulating volume. Myelodysplastic syndromes often do not cause early signs or symptoms, and can be found during routine blood tests. Granulocyte colony-stimulating factors (G-CSF) have been used in the treatment of myelodysplastic syndromes with neutropenia. Filgrastim, a G-CSF, helps increase the number of circulating neutrophils. Therefore, it has been proven to reduce patient vulnerability to infections in instances such as chemotherapy-induced neutropenia. This case report describes a 66-year-old male who presented for a pre-operative assessment before an elective left total hip arthroplasty. Routine bloodwork showed a low neutrophil count, and the surgery was cancelled due to concerns about the patient’s risk of infection. Further testing included a bone marrow aspirate and core biopsy that showed mild megaloblastic erythropoiesis and a relative increase in the proportion of myeloblasts and promyelocytes. The patient was given a working diagnosis of early myelodysplasia, and a trial of a low-dose G-CSF was started. The neutrophil count was monitored at 6–72 hours. After 72 hours of administration of filgrastim, the patient’s blood neutrophil levels had improved outside the range of neutropenia. After clearance for surgery, the patient had a successful hip arthroplasty with no post-operative infection reported. No neutropenia was noted post-surgery. This case highlights the potential of filgrastim to be used as prophylaxis before an elective surgery to improve moderate neutropenia related to primary myelodysplasia.","PeriodicalId":509115,"journal":{"name":"EMJ Hematology","volume":"36 20","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Filgrastim Used for Infection Prophylaxis for Moderate Neutropenia Related to Primary Myelodysplasia Prior to Elective Surgery: A Case Report\",\"authors\":\"Sonya Mannala, Emmett Harrison\",\"doi\":\"10.33590/emjhematol/fcvq4758\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Myelodysplastic syndromes are a group of disorders that affect the bone marrow, subsequently affecting the growth and relative abundance of blood-forming cells in the circulating volume. Myelodysplastic syndromes often do not cause early signs or symptoms, and can be found during routine blood tests. Granulocyte colony-stimulating factors (G-CSF) have been used in the treatment of myelodysplastic syndromes with neutropenia. Filgrastim, a G-CSF, helps increase the number of circulating neutrophils. Therefore, it has been proven to reduce patient vulnerability to infections in instances such as chemotherapy-induced neutropenia. This case report describes a 66-year-old male who presented for a pre-operative assessment before an elective left total hip arthroplasty. Routine bloodwork showed a low neutrophil count, and the surgery was cancelled due to concerns about the patient’s risk of infection. Further testing included a bone marrow aspirate and core biopsy that showed mild megaloblastic erythropoiesis and a relative increase in the proportion of myeloblasts and promyelocytes. The patient was given a working diagnosis of early myelodysplasia, and a trial of a low-dose G-CSF was started. The neutrophil count was monitored at 6–72 hours. After 72 hours of administration of filgrastim, the patient’s blood neutrophil levels had improved outside the range of neutropenia. After clearance for surgery, the patient had a successful hip arthroplasty with no post-operative infection reported. No neutropenia was noted post-surgery. This case highlights the potential of filgrastim to be used as prophylaxis before an elective surgery to improve moderate neutropenia related to primary myelodysplasia.\",\"PeriodicalId\":509115,\"journal\":{\"name\":\"EMJ Hematology\",\"volume\":\"36 20\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"EMJ Hematology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.33590/emjhematol/fcvq4758\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"EMJ Hematology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33590/emjhematol/fcvq4758","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

骨髓增生异常综合征是一组影响骨髓,进而影响循环容量中造血细胞的生长和相对丰度的疾病。骨髓增生异常综合征通常不会引起早期症状或体征,可在常规血液检查中发现。粒细胞集落刺激因子(G-CSF)已被用于治疗伴有中性粒细胞减少症的骨髓增生异常综合征。G-CSF中的Filgrastim有助于增加循环中性粒细胞的数量。因此,在化疗引起的中性粒细胞减少症等情况下,它已被证明能降低患者感染的可能性。本病例报告描述了一名 66 岁的男性患者在接受择期左全髋关节置换术前接受术前评估。血常规检查显示中性粒细胞计数偏低,由于担心患者有感染风险,手术被取消。进一步检查包括骨髓抽吸和核心活检,结果显示存在轻度巨幼红细胞生成,骨髓细胞和原幼红细胞的比例相对增加。患者被诊断为早期骨髓增生异常,并开始试用小剂量 G-CSF。6-72 小时后对中性粒细胞计数进行监测。在服用非格司亭 72 小时后,患者血液中的中性粒细胞水平有所改善,超出了中性粒细胞减少的范围。在获得手术许可后,患者成功地进行了髋关节置换术,术后没有感染报告。术后未发现中性粒细胞减少症。本病例强调了在择期手术前使用非格司亭作为预防药物,以改善与原发性骨髓增生异常相关的中性粒细胞减少症的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Filgrastim Used for Infection Prophylaxis for Moderate Neutropenia Related to Primary Myelodysplasia Prior to Elective Surgery: A Case Report
Myelodysplastic syndromes are a group of disorders that affect the bone marrow, subsequently affecting the growth and relative abundance of blood-forming cells in the circulating volume. Myelodysplastic syndromes often do not cause early signs or symptoms, and can be found during routine blood tests. Granulocyte colony-stimulating factors (G-CSF) have been used in the treatment of myelodysplastic syndromes with neutropenia. Filgrastim, a G-CSF, helps increase the number of circulating neutrophils. Therefore, it has been proven to reduce patient vulnerability to infections in instances such as chemotherapy-induced neutropenia. This case report describes a 66-year-old male who presented for a pre-operative assessment before an elective left total hip arthroplasty. Routine bloodwork showed a low neutrophil count, and the surgery was cancelled due to concerns about the patient’s risk of infection. Further testing included a bone marrow aspirate and core biopsy that showed mild megaloblastic erythropoiesis and a relative increase in the proportion of myeloblasts and promyelocytes. The patient was given a working diagnosis of early myelodysplasia, and a trial of a low-dose G-CSF was started. The neutrophil count was monitored at 6–72 hours. After 72 hours of administration of filgrastim, the patient’s blood neutrophil levels had improved outside the range of neutropenia. After clearance for surgery, the patient had a successful hip arthroplasty with no post-operative infection reported. No neutropenia was noted post-surgery. This case highlights the potential of filgrastim to be used as prophylaxis before an elective surgery to improve moderate neutropenia related to primary myelodysplasia.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信