Granulocyte macrophage colony stimulating factor: high incidence of apheresis catheter thrombosis during peripheral stem cell collection.
Granulocyte-macrophage colony stimulating factor (GM-CSF) has been used to augment circulating hemopoietic stem cells in the peripheral blood and promote efficient peripheral stem cell (PSC) collection. Anecdotal reports indicate that GM-CSF may contribute to apheresis catheter dysfunction during PSC collection. We prospectively evaluated thrombotic occlusion rate of inferior vena cava (IVC) catheters following introduction of GM-CSF compared with a control group who underwent PSC collection prior to introduction of GM-CSF. Both groups were given aspirin (325 mg daily). The active treatment group was given GM-CSF (starting dose 250 micrograms/m2/day) as continuous infusion via the IVC catheter. The rate of thrombotically occluded catheters increased from 1/29 (3%) to 20/37 (54%) (p < 0.0001). Thrombi developing during GM-CSF therapy were unusual as 25/36 (69%) occlusions cleared with mechanical clot aspiration and did not require lytic agents.
Stephens
L C
LC
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-1210.
Haire
W D
WD
Schmit-Pokorny
K
K
Kessinger
A
A
Kotulak
G
G
D001241:Aspirin / Q000494:pharmacology; D001781:Blood Component Removal / Q000009:adverse effects*; D001804:Blood Transfusion, Autologous; D016026:Bone Marrow Transplantation; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000187:drug effects; D006801:Humans; D011446:Prospective Studies; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control; D014682:Vena Cava, Inferior
D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D001241:Aspirin