{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T21:07:15Z","timestamp":1784408835922,"version":"3.55.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":181,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>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 are usually treated with glucocorticoids. Here, we report a case of G-CSF-induced aortitis complicated with intensive chemotherapy for Ewing\u2019s sarcoma, which was successfully treated with one bolus of intravenous tocilizumab, an anti-interleukin-6 inhibitor, resulting in early suppression of aortic inflammation and prompt resumption of chemotherapy. Our current case provides useful insights into the pathogenesis of G-CSF-induced aortitis and its treatment strategy with an interleukin-6 blockade without glucocorticoids.<\/jats:p>","DOI":"10.1093\/mrcr\/rxaf033","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:23:31Z","timestamp":1751358211000},"source":"Crossref","is-referenced-by-count":2,"title":["An IL-6 inhibitor subsides iatrogenic aortitis induced by granulocyte-colony stimulating factor without interruption of chemotherapy"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0001-1078","authenticated-orcid":false,"given":"Kanako","family":"Shimanuki","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1566-2088","authenticated-orcid":false,"given":"Yasushi","family":"Kondo","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takei","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironari","family":"Hanaoka","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"2025081214064409000_ref1","doi-asserted-by":"crossref","first-page":"2475","DOI":"10.1093\/annonc\/mdt226","article-title":"The impact of the granulocyte colony-stimulating factor on chemotherapy dose intensity and cancer survival: a systematic review and meta-analysis of randomized controlled trials","volume":"24","author":"Lyman","year":"2013","journal-title":"Ann Oncol"},{"key":"2025081214064409000_ref2","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.2169\/internalmedicine.0599-22","article-title":"Aortitis associated with prophylactic short-acting granulocyte colony-stimulating factor administration: a case report and review of the literature","volume":"62","author":"Masuda","year":"2023","journal-title":"Intern 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significance","volume":"51","author":"Lys\u00e1k","year":"2011","journal-title":"Transfusion."},{"key":"2025081214064409000_ref6","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1093\/rheumatology\/kez630","article-title":"Long-term efficacy and safety of tocilizumab in refractory Takayasu arteritis: final results of the randomized controlled phase 3 TAKT study","volume":"59","author":"Nakaoka","year":"2020","journal-title":"Rheumatology (Oxford)."},{"key":"2025081214064409000_ref7","doi-asserted-by":"crossref","first-page":"5882","DOI":"10.4049\/jimmunol.1201881","article-title":"IL-6 cooperates with G-CSF to induce protumor function of neutrophils in bone marrow by enhancing STAT3 activation","volume":"190","author":"Yan","year":"2013","journal-title":"J Immunol"},{"key":"2025081214064409000_ref8","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.cell.2010.01.025","article-title":"Immunity, inflammation, and cancer","volume":"140","author":"Grivennikov","year":"2010","journal-title":"Cell."},{"key":"2025081214064409000_ref9","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1186\/s12885-015-1564-7","article-title":"IL6 secreted by Ewing sarcoma tumor microenvironment confers anti-apoptotic and cell-disseminating paracrine responses in Ewing sarcoma cells","volume":"15","author":"Lissat","year":"2015","journal-title":"BMC Cancer"},{"key":"2025081214064409000_ref10","doi-asserted-by":"crossref","first-page":"1700130","DOI":"10.1002\/prca.201700130","article-title":"Current status of proteomics in Ewing\u2019s sarcoma","volume":"13","author":"Kondo","year":"2019","journal-title":"Proteomics Clin Appl"},{"key":"2025081214064409000_ref11","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/s12185-019-02662-6","article-title":"Arteritis after administration of granulocyte colony-stimulating factor: a case 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