Department of Hematology, The 920 Hospital of PLA Joint Logistics Support Force, No. 212, Daguan Road, Xishan District, Kunming, 650032, Yunnan Province, China.
Shanghai Tissuebank Biotechnology Co., Ltd, No. 908. Ziping Road, #21 Building, Pudong New District, Shanghai, 201318, China.
Int J Hematol. 2024 Aug;120(2):262-266. doi: 10.1007/s12185-024-03779-z. Epub 2024 May 10.
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.
聚乙二醇化重组人粒细胞集落刺激因子（PEG-rhG-CSF）已被用于动员外周血造血干细胞（PBSC）。然而，尚未有健康供者发生急性肺损伤（ALI）的报道，其潜在机制仍不清楚。我们首次报道了一例由 PEG-rhG-CSF 引起的健康中国供者的 ALI，表现为咯血、低氧血症和斑片状阴影。最终，激素治疗、计划的 PBSC 采集、白细胞清创术和计划的 PBSC 采集使供者的 ALI 得到了积极控制。供者的症状改善，无任何不良反应，PBSC 采集也未发生意外。随着时间的推移，肺部病变逐渐吸收，最终恢复正常。PEG-rhG-CSF 可能通过涉及中性粒细胞聚集、黏附和肺部炎症介质释放的机制导致健康供者的 ALI。本病例报告探讨了 PEG-rhG-CSF 动员 PBSC 引起的肺损伤的临床表现、治疗和机制。
