CMAJ • October 24, 2006; 175 (9). doi:10.1503/cmaj.1060064.
© 2006 CMA Media Inc. or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Letters

Granulocyte colony-stimulating factor

Kürsat Kaptan, Cengiz Beyan and Ahmet Ifran

Hematology Department, Gülhane Military Medical Academy, Ankara, Turkey

In the background section of their abstract, Woei-Cherng Shyu and associates1 state that because granulocyte colony-stimulating factor (G-CSF) has anti-inflammatory and neuroprotective properties and the capacity to mobilize stem cells, it has the potential to be used in treatment of stroke. However, there are limited data about the effects of G-CSF on hemostasis.2,3 It has been suggested that G-CSF may induce a hypercoagulable state, possibly by increasing levels of endothelial markers and thrombin generation or by stimulating tissue factor.4,5 A few reported cases of acute arterial thrombosis in patients receiving G-CSF support the hypothesis of induction of a transient hypercoagulable state.6,7 In addition, acute arterial thrombosis in healthy donors, possibly related to G-CSF, has been reported.2 A transient hypercoagulable state related to G-CSF may be important for thrombophilic, atherosclerotic or immobilized patients.

Therefore, whenever G-CSF is administered, the patient should be followed carefully.

REFERENCES

  1. Shyu WC, Lin SZ, Lee CC, et al. Granulocyte colony-stimulating factor for acute ischemic stroke: a randomized controlled trial. CMAJ 2006;174(7):927-33.[Abstract/Free Full Text]
  2. Anderlini P, Korbling M, Dale D, et al. Allogeneic blood stem cell transplantation: considerations for donors. Blood 1997;90:903-8.[Abstract/Free Full Text]
  3. Anderlini P, Rizzo JD, Nugent ML, et al. Peripheral blood stem cell donation: an analysis from the International Bone Marrow Transplant Registry (IBMTR) and European Group for Blood and Marrow Transplant (EBMT) databases. Bone Marrow Transplant 2001;27(7):689-92.[CrossRef][Medline]
  4. LeBlanc R, Roy J, Demers C, et al. A prospective study of G-CSF effects on hemostasis in allogeneic blood stem cell donors. Bone Marrow Transplant 1999;23:991-6.[CrossRef][Medline]
  5. Topçuoglu P, Arat M, Dalva K, et al. Administration of granulocyte-colony-stimulating factor for allogeneic hematopoietic cell collection may induce the tissue factor-dependent pathway in healthy donors. Bone Marrow Transplant 2004;33:171-6.[CrossRef][Medline]
  6. Conti JA, Scher HI. Acute arterial thrombosis after escalated-dose methotrexate, vinblastine, doxorubicin, and cisplatin chemotherapy with recombinant granulocyte colony-stimulating factor. A possible new recombinant granulocyte colony-stimulating factor toxicity. Cancer 1992;70(11):2699-702.[CrossRef][Medline]
  7. Lindemann A, Rumberger B. Vascular complications in patients treated with granulocyte colony-stimulating factor (G-CSF). Eur J Cancer 1993;29A:2338-9.[CrossRef]




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