Two Cases of Pegfilgrastim-induced Aortitis in Patients with Breast Cancer

Abstract

An increasing number of cases with G-CSF induced aortitis have been reported in recent times. However, but sufficient information has not been provided yet. We report two cases of aortitis after pegfilgrastim administration during post-operative adjuvant chemotherapy. The first case was that of a 78-year-old woman who underwent right mastectomy and axillary lymph node dissection (invasive lobal carcinoma, ER+, PgR+, HER2-, Ki67<1%, pT2N2aM0 Stage IIIA). Pegfilgrastim was administered on day 3 of the first course, after post-operative TC (docetaxel + cyclophosphamide) therapy was started. Fever and inflammatory responses were observed from day 6 of pegfilgrastim adminstration.

The second case was that of a 70-year-old woman who underwent right mastectomy (invasive ductal carcinoma, ER+, PgR+, HER2(2+) : FISH(-), Ki67 20.2% pT1cN0M0 Stage IA). After post-operative TC therapy was started, Pegfilgrastim was administered on day 3 of the first course, after starting post-operative TC therapy. From Day 13 onwards, fever, low back pain, and an increased inflammatory response were observed. CT findings were useful for diagnosis in both cases. The spread of G-CSF preparations may cause an increase in the number of cases of aortitis. Further examination is therefore, considered necessary.