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Hematopoietic Growth Factors

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

Bone Marrow Transplantation volume 33, pages 171–176 (2004)Cite this article

Summary:

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 μg/kg/day × 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.

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Acknowledgements

This study was supported by Ankara University Research Fund (99-09-00-006)

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  1. Department of Hematology, Ankara University School of Medicine, Sihhiye, Ankara, Turkey

    P Topcuoglu, M Arat, K Dalva & M Özcan

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  1. P Topcuoglu
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  2. M Arat
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  3. K Dalva
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  4. M Özcan
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Correspondence to M Özcan.

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Topcuoglu, 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 33, 171–176 (2004). https://doi.org/10.1038/sj.bmt.1704341

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