Administration of granulocyte-colony-stimulating factor for allogeneic hematopoietic cell collection may induce the tissue factor-dependent pathway in healthy donors

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Topcuoglu P., Arat M., Dalva K., Ozcan M.

BONE MARROW TRANSPLANTATION, vol.33, no.2, pp.171-176, 2004 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 2
  • Publication Date: 2004
  • Doi Number: 10.1038/sj.bmt.1704341
  • Journal Name: BONE MARROW TRANSPLANTATION
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.171-176
  • Keywords: rhG-CSF, tissue factor, hypercoagulability, peripheral blood stem cell collection, ACUTE ARTERIAL THROMBOSIS, BONE-MARROW, ENDOTHELIAL-CELLS, HEMOSTASIS, ACTIVATION
  • Ankara University Affiliated: Yes

Abstract

The hypercoagulable state caused by the use of recombinant human granulocyte colony-stimulating factor (rhG-CSF) has been cited in anecdotal reports. Since tissue factor (TF) is the main initiator of the coagulation cascade, we examined if rhG-CSF had an inductive effect on the TF-dependent pathway in 18 healthy donors receiving rhG-CSF (10 mug/kg/day x 5 days) for peripheral blood progenitor cell mobilization. After rhG-CSF, there were increases both in TF antigen (TF:Ag) (P = 0.01) and TF procoagulant activity (TF:PCA) (P = 0.06) plasma levels and in TF:Ag cytofluorimetric expression on CD33 (+) cells (P = 0.04). Mean activities of FVIII and vWF also increased significantly. Thrombin time was slightly prolonged (P = 0.06) due to significant increases in plasma D-dimer levels. In addition, while FIX activity remained stable, there were marked reductions in mean plasma FX and FII activities and a slight decrease in FVII activity that resulted in a significant prolongation of prothrombin time within normal ranges. In conclusion, the administration of rhG-CSF led to a 'prothrombotic state' via stimulation of TF and increased endothelial markers, such as F VIII and vWF. In the light of these findings, the use of rhG-CSF for stem cell mobilization should be undertaken cautiously in healthy donors with underlying thrombotic risk factors.