G-CSF-induced severe thrombocytopenia in a healthy donor

Abstract

Rationale: Granulocyte colony-stimulating factor (G-CSF) is most frequently used in healthy donors to mobilize progenitor cells into the peripheral blood for collection. While mild thrombocytopenia is common in allogeneic peripheral blood stem cell transplant donors after G-CSF mobilization, serious thrombocytopenia is rarely reported. Herein, we report a case of severe thrombocytopenia caused by G-CSF in a 14-year-old healthy donor and review the relevant literature. To our knowledge, this is the first reported case of severe thrombocytopenia caused by G-CSF in a healthy adolescent donor. Patient concerns: A 14-year-old sister of a girl with T lymphocyte leukemia was selected as a matched donor for transplantation. The donor was healthy with normal blood parameters. Diagnoses: The donor received 10 μg/kg/day G-CSF via subcutaneous injection. On day 4 of G-CSF administration, blood tests before stem cell collection indicated that platelets dropped to 51 g/L. Abdominal ultrasound showed that the spleen was mildly enlarged. Interventions: In order to prevent blood loss and other effects caused by a too low platelet count after collection, the donor's peripheral blood hematopoietic stem cells were collected after platelet transfusion. Outcomes: Checkups for 1 year after G-CSF administration showed normal blood parameters. Lessons: Due to the rare risk of severe thrombocytopenia in G-CSF mobilization, it is necessary to routinely monitor blood parameters during mobilization to ensure smooth progress of the transplantation process.

Is It Better to Mobilize Hematopoietic Stem Cells With Pegfilgrastim in Healthy Donors During Allogeneic Hematopoietic Stem Cell Transplantation?

“…Thrombocytopenia was also reported in another pegfilgrastim-induced mobilization study, and platelet nadirs remained at acceptable levels (21). Nevertheless, a case of severe thrombocytopenia caused by G-CSF in a 14-year-old healthy donor was reported, and HSCs were collected after platelet transfusion (25). This effect was not specific to peg-G-CSF compared with G-CSF.…”

The role of granulocyte colony‑stimulating factor in breast cancer development: A review

“…Secreted G-cSF not only has an antiapoptotic effect but also promotes the formation of tumors by mobilizing MdScs to inhibit T cell activity and Bv8 secretion (12). in some clinical case reports, the use of safe therapeutic doses of G-cSF may cause unpredictable side effects such as bone pain, local skin reactions at the injection site and even spleen rupture or infarction (93)(94)(95)(96). This evidence also raised concerns for clinical work.…”

Therapeutic effects of coronary granulocyte colony-stimulating factor on rats with chronic ischemic heart disease

“…However, there are few relevant studies for patients with chronic myocardial ischemia or old myocardial infarction, and the results are inconsistent [ 5 ]. Moreover, subcutaneous injection in clinical practice usually requires continuous injection for 3–7 consecutive days and even more than 10 days, and a large amount of G-CSF injection may result in hypercoagulable blood, increasing the risk of recurrent angina or myocardial infarction [ 6 ]. Therefore, we intended to study whether other injection routes can be used to reduce the amount of G-CSF while improving the cardiac function, which, in turn, may reduce adverse reactions after G-CSF mobilization.…”