title: Acute lung Injury in a healthy donor during mobilization of peripheral blood stem cells using granulocyte-colony stimulating factor alone.
abstract: Granulocyte-colony stimulating factor (G-CSF), a hematopoietic growth factor, is widely used to accelerate recovery from neutropenia after severe chemotherapy, both decreasing the risk of infection and mobilizing peripheral blood stem cells. Adverse effects occur with G-CSF use in approximately 30% of cases, comprised predominantly of bone pain, headache, and general fatigue. Pulmonary toxicity is very rare. Here, we describe a healthy donor for allogeneic hematopoietic stem cell transplantation who developed acute lung injury (ALI) after 4 days of G-CSF administration. Among the serum cytokines examined, only Interleukin (IL)-1beta level was elevated in this case. As a high level of IL-1beta was detected at the onset of ALI, on day 4 after G-CSF administration, and decreased to below the level of detection on day 11, it is possible in a certain part that IL-1beta was involved in the onset of G-CSF-related ALI in the present case. Granulocyte-colony stimulating factor (G-CSF) is commonly administered to healthy donors to mobilize peripheral blood stem cells (PBSC) for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Adverse events from G-CSF use in healthy donors have been described in approximately 30% of cases, and are comprised predominantly of bone pain, headache, and general fatigue. Pulmonary complications caused by G-CSF include cough, dyspnea, and interstitial or alveolar pulmonary edema with mild-to-severe deterioration of blood oxygen level. Few cases of acute respiratory distress syndrome (ARDS) following G-CSF administration have been reported. The present report describes a healthy donor for allo-HSCT with acute lung injury (ALI) after 4 days of G-CSF administration. The cytokine-related mechanisms of G-CSF administration that contribute to ALI are discussed.
authors.affiliation: Department of Hematology and Immunology, Kagoshima University Hospital, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Arimura
authors.forename: Hirosaka
authors.initials: H
authors.lastname: Inoue
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Kukita
authors.forename: Kakushi
authors.initials: K
authors.lastname: Matsushita
authors.forename: Masaki
authors.initials: M
authors.lastname: Akimot
authors.forename: Nakaaki
authors.initials: N
authors.lastname: Kawamata
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kawada
authors.forename: Atsuo
authors.initials: A
authors.lastname: Ozak
authors.forename: Naomichi
authors.initials: N
authors.lastname: Arima
authors.forename: Chuwa
authors.initials: C
authors.lastname: Te
mesh_terms: D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects*; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects* / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000139:chemically induced*; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D016179:Granulocyte Colony-Stimulating Factor