Granulocyte macrophage colony stimulating factor: high incidence of apheresis catheter thrombosis during peripheral stem cell collection

Bone Marrow Transplant. 1993 Jan;11(1):51-4.

Abstract

Granulocyte-macrophage colony stimulating factor (GM-CSF) has been used to augment circulating hemopoietic stem cells in the peripheral blood and promote efficient peripheral stem cell (PSC) collection. Anecdotal reports indicate that GM-CSF may contribute to apheresis catheter dysfunction during PSC collection. We prospectively evaluated thrombotic occlusion rate of inferior vena cava (IVC) catheters following introduction of GM-CSF compared with a control group who underwent PSC collection prior to introduction of GM-CSF. Both groups were given aspirin (325 mg daily). The active treatment group was given GM-CSF (starting dose 250 micrograms/m2/day) as continuous infusion via the IVC catheter. The rate of thrombotically occluded catheters increased from 1/29 (3%) to 20/37 (54%) (p < 0.0001). Thrombi developing during GM-CSF therapy were unusual as 25/36 (69%) occlusions cleared with mechanical clot aspiration and did not require lytic agents.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Aspirin / pharmacology
  • Blood Component Removal / adverse effects*
  • Blood Transfusion, Autologous
  • Bone Marrow Transplantation
  • Catheterization, Central Venous / adverse effects*
  • Granulocyte-Macrophage Colony-Stimulating Factor / adverse effects*
  • Hematopoietic Stem Cell Transplantation
  • Hematopoietic Stem Cells / drug effects
  • Humans
  • Prospective Studies
  • Thrombosis / etiology*
  • Thrombosis / prevention & control
  • Vena Cava, Inferior

Substances

  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Aspirin