Quillen Karen, Byrne Phyllis, Yau Yu Ying, Leitman Susan F
Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Transfusion. 2009 Mar;49(3):513-8. doi: 10.1111/j.1537-2995.2008.01983.x.
The combination of granulocyte-colony-stimulating factor (G-CSF) and dexamethasone is an effective granulocyte mobilization regimen. The short-term side effects of G-CSF are well studied, but the potential long-term effects of repeated G-CSF stimulation in unrelated volunteer granulocyte donors have not been reported.
Donors who had received G-CSF three or more times for granulocytapheresis between 1994 and 2002 were identified and attempts were made to contact them if they were no longer active donors. They were matched with control platelet (PLT) donors for sex, age, and approximate number of cytapheresis donations. A health history was obtained and complete blood counts (CBCs) and C-reactive protein (CRP) determined where feasible.
Ninety-two granulocyte donors were identified, and 83 of them were contacted. They contributed to 1120 granulocyte concentrates, or a mean of 13.5 granulocytapheresis procedures per donor (and a mean of 87.5 plateletpheresis procedures per donor). There was no difference in CBCs between the granulocyte donors and the control PLT donors. There was no difference in CRP between the two groups, and no difference in pre- and post-G-CSF CRP in a subset of 22 granulocyte donors. Predefined health events included malignancies, coronary artery disease, and thrombosis. At a median 10-year follow-up, there were seven such events in the granulocyte donors and five in the PLT donors.
Although the number of granulocyte donors studied is small and continued surveillance of healthy individuals after G-CSF is prudent, our data suggest that G-CSF/dexamethasone stimulation appears to be safe.
粒细胞集落刺激因子(G-CSF)与地塞米松联合使用是一种有效的粒细胞动员方案。G-CSF的短期副作用已得到充分研究,但对于非亲属志愿粒细胞供者反复接受G-CSF刺激的潜在长期影响尚未见报道。
确定1994年至2002年间因粒细胞单采而接受过3次或更多次G-CSF治疗的供者,若他们不再是活跃供者,则尝试与其联系。将他们与对照血小板(PLT)供者在性别、年龄和血细胞单采捐献次数方面进行匹配。获取健康史,并在可行的情况下测定全血细胞计数(CBC)和C反应蛋白(CRP)。
共确定92名粒细胞供者,其中83名被联系上。他们捐献了1120份粒细胞浓缩物,每位供者平均进行了13.5次粒细胞单采程序(每位供者平均进行了87.5次血小板单采程序)。粒细胞供者与对照PLT供者的CBC无差异。两组间CRP无差异,22名粒细胞供者亚组中G-CSF治疗前后的CRP也无差异。预先定义的健康事件包括恶性肿瘤、冠状动脉疾病和血栓形成。在中位10年的随访中,粒细胞供者中有7例此类事件,PLT供者中有5例。
尽管所研究的粒细胞供者数量较少,且在G-CSF治疗后对健康个体进行持续监测是谨慎的,但我们的数据表明,G-CSF/地塞米松刺激似乎是安全的。