Söhngen D, Wienen S, Siebler M, Boogen C, Scheid C, Schulz A, Kobbe G, Diehl V, Heyll A
Department of Internal Medicine, University of Köln, Germany.
Bone Marrow Transplant. 1998 Dec;22(11):1087-90. doi: 10.1038/sj.bmt.1701481.
Experimental evidence suggests a stimulatory effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) on both platelets and coagulation. RhG-CSF is increasingly used to stimulate healthy volunteer donors for blood stem cell mobilization. We therefore assessed 25 healthy donors receiving rhG-CSF for changes in in vitro bleeding test (IVBT), coagulation parameters and cerebral microembolism by transcranial Doppler (TCD) ultrasound. A significant shortening of IVBT was found on day 4 of rhG-CSF administration together with increased levels of fibrinogen and factor VIII and reduced activities of protein C and protein S. Although these changes are quite small it is possible that they may lead to a hypercoagulable state especially in donors with other risk factors for thromboembolism. However, TCD examination failed to detect any signs of microembolism. We therefore conclude that rhG-CSF leads to significant changes in coagulation parameters, but has no effect on TCD detectable microembolism as a stroke risk factor. However donors receiving rhG-CSF should be examined carefully to detect pre-existing changes in the coagulation system and we would like to suggest a routine thrombophilia screen.
实验证据表明重组人粒细胞集落刺激因子（rhG-CSF）对血小板和凝血均有刺激作用。rhG-CSF越来越多地用于刺激健康志愿者捐献者以进行造血干细胞动员。因此，我们评估了25名接受rhG-CSF的健康捐献者，通过经颅多普勒（TCD）超声检测其体外出血试验（IVBT）、凝血参数和脑微栓塞的变化。在给予rhG-CSF的第4天，发现IVBT显著缩短，同时纤维蛋白原和因子VIII水平升高，蛋白C和蛋白S活性降低。尽管这些变化非常小，但尤其是在具有其他血栓栓塞危险因素的捐献者中，它们有可能导致高凝状态。然而，TCD检查未检测到任何微栓塞迹象。因此，我们得出结论，rhG-CSF会导致凝血参数发生显著变化，但作为中风危险因素，对TCD可检测到的微栓塞没有影响。然而，应对接受rhG-CSF的捐献者进行仔细检查，以发现凝血系统预先存在的变化，我们建议进行常规血栓形成倾向筛查。
