A case of acute lung injury in a peripheral blood stem cell donor mobilized with pegylated recombinant human granulocyte colony-stimulating factor

Int J Hematol. 2024 Aug;120(2):262-266. doi: 10.1007/s12185-024-03779-z. Epub 2024 May 10.

Abstract

Pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) has been introduced for the mobilization of peripheral blood stem cells (PBSCs). However, no cases of acute lung injury (ALI) in healthy donors have been reported, and the underlying mechanisms remain poorly understood. We first reported a case of ALI caused by PEG-rhG-CSF in a healthy Chinese donor, characterized by hemoptysis, hypoxemia, and patchy shadows. Ultimately, hormone administration, planned PBSC collection, leukocyte debridement, and planned PBSC collection resulted in active control of the donor's ALI. The donor's symptoms improved without any adverse effects, and the PBSC collection proceeded without incident. Over time, the lung lesion was gradually absorbed and eventually returned to normal. PEG-rhG-CSF may contribute to ALI in healthy donors via mechanisms involving neutrophil aggregation, adhesion, and the release of inflammatory mediators in the lung. This case report examines the clinical manifestations, treatment, and mechanism of lung injury induced by PEG-rhG-CSF-mobilized PBSCs.

Keywords: Acute lung injury; Adverse effect; Healthy donor; Pegylated recombinant human granulocyte colony-stimulating factor; Peripheral blood stem cell mobilization.

Publication types

  • Case Reports

MeSH terms

  • Acute Lung Injury* / chemically induced
  • Acute Lung Injury* / etiology
  • Adult
  • Blood Donors
  • Granulocyte Colony-Stimulating Factor* / administration & dosage
  • Granulocyte Colony-Stimulating Factor* / adverse effects
  • Hematopoietic Stem Cell Mobilization* / adverse effects
  • Hematopoietic Stem Cell Mobilization* / methods
  • Humans
  • Male
  • Peripheral Blood Stem Cell Transplantation / adverse effects
  • Peripheral Blood Stem Cells
  • Polyethylene Glycols* / adverse effects
  • Recombinant Proteins* / administration & dosage
  • Recombinant Proteins* / adverse effects
  • Recombinant Proteins* / therapeutic use
  • Tissue Donors

Substances

  • Granulocyte Colony-Stimulating Factor
  • Recombinant Proteins
  • Polyethylene Glycols
  • pegylated granulocyte colony-stimulating factor, human