Granulocyte colony-stimulating factor (G-CSF) is used in healthy donors of peripheral blood stem cells (PBSC) for allogeneic transplantation. However, some data have recently suggested that G-CSF may induce a hypercoagulable state, prompting us to study prospectively 22 PBSC donors before and after G-CSF 5 μg/kg twice daily. We sought evidence for changes in the following parameters: platelet count, von Willebrand factor antigen (vWF:Ag) and activity (vWF activity), β-thromboglobulin (β-TG), platelet factor 4 (PF-4), platelet activation markers (GMP-140 and PAC-1), activated partial thromboplastin time (aPTT), prothrombin time (PT), coagulant factor VIII (FVIII:C), thrombin-antithrombin complex (TAT), prothrombin fragment 1 + 2 (F1 + 2), thrombomodulin (TM) and tissue plasminogen activator antigen (tPA:Ag) prior to G-CSF and immediately before leukapheresis. ADP-induced platelet aggregation studies were also performed. G-CSF administration produced only mild discomfort. We found a significant increase in vWF:Ag (from 0.99 ± 0.32 U/ml to 1.83 ± 0.69 U/ml; P < 0.001), in vWF activity (from 1.04 ± 0.34 U/ml to 1.78 ± 0.50 U/ml; P < 0.001) and in FVIII:C (from 1.12 ± 0.37 U/ml to 1.73 ± 0.57 U/ml; P < 0.001) after G-CSF. Of note, four donors with low baseline vWF had a two- to three-fold increase after receiving G-CSF. GCSF had no impact on the platelet count, β-TG, PF-4, GMP-140 or PAC-1. The final% of platelet aggregation decreased from 73 ± 22% to 37 ± 26% after G-CSF (P < 0.001). We found a significant decrease in aPTT after G-CSF (29.9 ± 3.1 s to 28.3 ± 3.3 s; P = 0.004), but the PT was unaffected. In addition, we also observed a significant increase in TAT, F1 + 2 and TM, but not in tPA:Ag. Our data suggest that G-CSF may possibly induce a hypercoagulable state by increasing levels of FVIII:C and thrombin generation. In contrast to this information, we found reduced platelet aggregation after G-CSF administration. The clinical implications of these findings remain unclear and larger studies are definitely required.
- Granulocyte colony-stimulating factor
- Healthy peripheral blood stem cell donors
- Platelet activation
ASJC Scopus subject areas