Karadogan Cavidan, Karadogan Ihsan, Bilgin Aynur Ugur, Undar Levent
Division of Hematology, Department of Internal Medicine, Akdeniz University School of Medicine, Antalya, Turkey.
Ther Apher Dial. 2006 Apr;10(2):180-6. doi: 10.1111/j.1744-9987.2006.00361.x.
Several reports have shown that granulocyte colony-stimulating factor (G-CSF) administration induces a transient, mild hypercoagulable state, which might predispose certain donors to thrombotic complications. In the present study, changes in the expression of neutrophil adhesion molecules (CD11b/CD18, CD62L) and platelet-neutrophil complex formation following rHuG-CSF administration were investigated in normal granulocyte and stem cell donors. For granulocyte apheresis (N = 10), rHuG-CSF (5 microg/kg) was given subcutaneously every 12 h three times and apheresis was carried out two hours after the last dose. For stem cell apheresis (N = 8), rHuG-CSF (10 microg/kg/day) was given subcutaneously for 5 days and apheresis was carried out when peripheral CD34+ cell counts exceeded 20 cell/microL. Expression of neutrophil adhesion molecules (CD11b/CD18, CD62L) and platelet-neutrophil complex formation following rHuG-CSF administration were investigated in donors by a flow cytometric method. A significant increase in neutrophil counts (P < 0.001), and decreases in platelet counts (P < 0.01) and hemoglobin levels (P < 0.01) occurred following G-CSF administration. The expression of CD11b/CD18 significantly increased (P < 0.001) over pretreatment values with G-CSF administration and returned to baseline 1 week after stopping the drug. In contrast, CD62L expression was decreased (P < 0.01) with G-CSF and returned to normal after cessation of the drug. rHuG-CSF caused more than a two-fold increase (from 0.3 to 7.0 x 10(9)/L) in circulating platelet-neutrophil complexes (P < 0.01), which returned to normal after 1 week. Although clinical significance of these laboratory changes is not clear, the occurrence of neutrophil activation and increased platelet-neutrophil complex formation might predispose certain donors or patients to thrombotic complications following G-CSF administration.
几份报告显示，给予粒细胞集落刺激因子（G-CSF）会诱发短暂、轻度的高凝状态，这可能使某些献血者易发生血栓并发症。在本研究中，对正常粒细胞和干细胞献血者给予重组人粒细胞集落刺激因子（rHuG-CSF）后中性粒细胞黏附分子（CD11b/CD18、CD62L）表达及血小板-中性粒细胞复合物形成的变化进行了研究。对于粒细胞单采（N = 10），每12小时皮下注射rHuG-CSF（5微克/千克），共3次，最后一剂后2小时进行单采。对于干细胞单采（N = 8），皮下注射rHuG-CSF（10微克/千克/天），共5天，当外周血CD34+细胞计数超过20个/微升时进行单采。采用流式细胞术研究了献血者给予rHuG-CSF后中性粒细胞黏附分子（CD11b/CD18、CD62L）表达及血小板-中性粒细胞复合物形成情况。给予G-CSF后中性粒细胞计数显著增加（P < 0.001），血小板计数（P < 0.01）和血红蛋白水平（P < 0.01）降低。给予G-CSF后，CD11b/CD18表达较预处理值显著增加（P < 0.001），停药1周后恢复至基线水平。相比之下，给予G-CSF后CD62L表达降低（P < 0.01），停药后恢复正常。rHuG-CSF使循环血小板-中性粒细胞复合物增加了两倍多（从0.3增至7.0×10⁹/L）（P < 0.01），1周后恢复正常。虽然这些实验室变化的临床意义尚不清楚，但中性粒细胞活化及血小板-中性粒细胞复合物形成增加可能使某些献血者或患者在给予G-CSF后易发生血栓并发症。
