Neutrophil dysplasia characterised by a pseudo-Pelger-Huet anomaly occurring with the use of mycophenolate mofetil and ganciclovir following renal transplantation: a report of five cases

Kennedy, Glen A., Kay, Troy D., Johnson, D. W., Hawley, Carmel M., Campbell, Scott B., Isbel, Nikky M.., Marlton, Paula, Cobcroft, Ralph, Gill, Devinder and Cull, Gavin (2002) Neutrophil dysplasia characterised by a pseudo-Pelger-Huet anomaly occurring with the use of mycophenolate mofetil and ganciclovir following renal transplantation: a report of five cases. Pathology, 34 3: 263-266.


Author Kennedy, Glen A.
Kay, Troy D.
Johnson, D. W.
Hawley, Carmel M.
Campbell, Scott B.
Isbel, Nikky M..
Marlton, Paula
Cobcroft, Ralph
Gill, Devinder
Cull, Gavin
Title Neutrophil dysplasia characterised by a pseudo-Pelger-Huet anomaly occurring with the use of mycophenolate mofetil and ganciclovir following renal transplantation: a report of five cases
Journal name Pathology   Check publisher's open access policy
ISSN 0031-3025
Publication date 2002-06
Sub-type Article (original research)
DOI 10.1080/0031302022013136
Volume 34
Issue 3
Start page 263
End page 266
Total pages 4
Editor Royal College of Pathologists of Australia
Place of publication Colchester, UK
Publisher Taylor & Francis
Collection year 2002
Language eng
Subject C1
730115 Urogenital system and disorders
110312 Nephrology and Urology
Abstract Aim: The pseudo-Pelger-Huet (PH) anomaly has been associated with a variety of primary haematological disorders, infections and drugs. Recently, the development of dysgranulopoiesis characterised by a pseudo-PH anomaly has been reported in two patients with the use of mycophenolate mofetil (MMF) in the setting of heart and/or lung transplantation. We present a further five cases of MMF-related dysgranulopoiesis characterised by a pseudo-PH anomaly occurring after renal transplantation. Methods: All patients were receiving standard immunosuppression protocols for renal transplantation, including a combination of MMF, steroids and either cyclosporin or tacrolimus. Oral ganciclovir was also used for cytomegalovirus prophylaxis in each case. Results: Development of dysplastic granulopoiesis occurred a median of 96 days (range 66-196 days) after transplantation. Moderate or severe neutropaenia (<1.0x10(9)/l) developed in three cases, and appeared to be directly correlated with the percentage of circulating neutrophils present with dysplastic morphology. Resolution of dysgranulopoiesis occurred in all cases only after dose reduction and/or cessation of both MMF and ganciclovir. Conclusions: In our series, the observed dysplastic granulopoiesis appeared related to the combination of MMF and ganciclovir, rather than MMF alone. Further study is required to determine the exact incidence and pathogenesis of this pattern of bone marrow toxicity.
Keyword Pathology
Dysgranulopoiesis
Ganciclovir
Mycophenolate Mofetil
Neutropenia
Neutropaenia
Pseudo-pelger-huet Anomaly
Acid
Therapy
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 16 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 19 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Access Statistics: 156 Abstract Views  -  Detailed Statistics
Created: Tue, 14 Aug 2007, 17:48:43 EST