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Clinical Challenges

Pegfilgrastim-Induced Pain in Patients With Lymphoma

Ellen C. Mullen
ONF 2014, 41(2), 212-214 DOI: 10.1188/14.ONF.212-214

A 56-year-old Caucasian woman named Ms. P was diagnosed with diffuse large-cell lymphoma with aggressive features. Her presenting symptoms included fever, weight loss, and drenching night sweats, with disease present in mesenteric, inguinal, and axillary lymph nodes as well as in her bone marrow. Ms. P has multiple comorbidities including diabetes, hypertension, gout, osteoarthritis, and hyperlipidemia. Ms. P presented to the clinic to discuss treatment options. Her oncologist recommended chemotherapy with rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (R+EPOCH) for six cycles with intrathecal chemotherapy prophylaxis and pegfilgrastim support. Ms. P agreed with the treatment plan and was admitted to receive chemotherapy. She tolerated the treatment well without any significant side effects or adverse events. She was discharged and returned to clinic after 24 hours to receive the pegfilgrastim.

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