Induction of a hypercoagulability state and endothelial cell activation by granulocyte colony-stimulating factor in peripheral blood stem cell donors.
In June, 1997, we initiated a prospective study to analyze the effect of granulocyte colony-stimulating factor (G-CSF) on coagulation system in peripheral blood stem cells (PBSC) donors following G-CSF administration. Since, 25 consecutively healthy donors received G-CSF (filgrastim) to mobilize and collect PBSC and 20 donors were finally included in the study. Blood samples were collected immediately before starting G-CSF and prior to PBSC collection to analyze the following parameters: prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, hypercoagulability markers (D-dimer, TAT complex, F1 + 2), natural anticoagulants (antithrombin, protein C, protein S), endothelial activation markers [von Willebrand factor antigen (vWF:Ag) and angiotensin converting enzyme (ACE)], and resistance to activated protein C. We found a significant increase in F1 + 2 and D-dimer while a significant decrease of antithrombin and protein C activity was evidenced. Regarding endothelial cell activation markers, a significant increase of vWF:Ag with a slightly significant decrease of ACE were also observed. Therefore, in PBSC donors receiving G-CSF our results reveal activation of both coagulation and endothelial cells that could favor the developing of thrombotic events. In consequence, a careful monitoring should be considered in those cases with risk factors for thrombosis.
Hematology Department and Investigation Unit, University Hospital La Paz, 28046 Madrid, Spain. miguelcanales@jazzfree.com
Miguel A
MA
Canales
Rosario
R
Arrieta
Ruben
R
Gomez-Rioja
Jesus
J
Diez
Victor
V
Jimenez-Yuste
Fernando
F
Hernandez-Navarro
D000293:Adolescent; D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D001781:Blood Component Removal / Q000379:methods; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011446:Prospective Studies; D011517:Prothrombin Time; D011994:Recombinant Proteins; D019851:Thrombophilia / Q000097:blood / Q000503:physiopathology*; D014019:Tissue Donors; D014841:von Willebrand Factor / Q000032:analysis
D011994:Recombinant Proteins; D014841:von Willebrand Factor; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim