Transient respiratory disturbance by granulocyte-colony-stimulating factor administration in healthy donors of allogeneic peripheral blood progenitor cell transplantation

Transfusion. 2006 Feb;46(2):186-92. doi: 10.1111/j.1537-2995.2006.00700.x.

Abstract

Background: Allogeneic peripheral blood progenitor cell (PBPC) transplantation requires granulocyte-colony-stimulating factor (G-CSF) administration to mobilize PBPCs in healthy donors. The effects of G-CSF on pulmonary functions, however, have not been clearly elucidated in PBPC donors.

Study design and methods: Respiratory status by measurements of arterial blood gas was prospectively evaluated serially in 25 healthy donors (9 men, 16 women; age, 18-61 years) administered a dose of 10 microg per kg for 5 days.

Results: White blood cell (WBC) counts increased in all the subjects after G-CSF administration; means on Days 0, 3, and 5 were 6 x 10(9), 33.4 x 10(9), and 33.6 x 10(9) per L, respectively. The mean PaO(2) values on the respective days were 93.1, 85.8, and 81.8 mmHg, and these changes were significant (p < 0.0001), remaining significant after adjustment for the WBC count. Levels of both PaCO(2) and AaDO(2) were significantly higher after G-CSF administration than those before G-CSF administration (p < 0.0001 and p = 0.0004, respectively). SaO(2) was significantly decreased after G-CSF administration (p = 0.0002). Age was identified as a significant predictive factor for the increase of AaDO(2) and PaO(2) decline. These observations clearly indicate that the gas exchange was significantly affected during G-CSF administration in healthy PBPC donors.

Conclusion: Considering an increasing use of PBPC mobilization by G-CSF, careful monitoring of the respiratory status is important to ensure safety of PBPC donors, especially elderly donors.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Blood Gas Analysis
  • Carbon Dioxide / blood
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / adverse effects*
  • Hematopoietic Stem Cell Mobilization / adverse effects*
  • Hematopoietic Stem Cell Mobilization / methods*
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Oxygen / blood
  • Peripheral Blood Stem Cell Transplantation*
  • Prospective Studies
  • Pulmonary Gas Exchange / drug effects
  • Respiratory Insufficiency / chemically induced*
  • Respiratory Insufficiency / physiopathology
  • Transplantation, Homologous

Substances

  • Carbon Dioxide
  • Granulocyte Colony-Stimulating Factor
  • Oxygen