TY - JOUR T1 - A prospective study of G-CSF effects on hemostasis in allogeneic blood stem cell donors JF - Bone Marrow Transplant Y1 - 1999 A1 - LeBlanc,R. A1 - Roy,J. A1 - Demers,C. A1 - Vu,L. A1 - Cantin,G. KW - *Tissue Donors KW - Adult KW - Blood Coagulation Disorders / chemically induced KW - Cohort Studies KW - Factor VIII / metabolism KW - Female KW - Filgrastim / administration & dosage / *adverse effects KW - Hematopoietic Stem Cell Mobilization / *adverse effects KW - Hematopoietic Stem Cell Transplantation KW - Hemostasis / *drug effects KW - Humans KW - Male KW - Middle Aged KW - Platelet Aggregation / drug effects KW - Prospective Studies KW - Thrombin / biosynthesis KW - Transplantation, Homologous KW - von Willebrand Factor / metabolism AB - Granulocyte colony-stimulating factor (G-CSF) is used in healthy donors of peripheral blood stem cells (PBSC) for allogeneic transplantation. However, some data have recently suggested that G-CSF may induce a hypercoagulable state, prompting us to study prospectively 22 PBSC donors before and after G-CSF 5 microg/kg twice daily. We sought evidence for changes in the following parameters: platelet count, von Willebrand factor antigen (vWF:Ag) and activity (vWF activity), beta-thromboglobulin (beta-TG), platelet factor 4 (PF-4), platelet activation markers (GMP-140 and PAC-1), activated partial thromboplastin time (aPTT), prothrombin time (PT), coagulant factor VIII (FVIII:C), thrombin-antithrombin complex (TAT), prothrombin fragment 1+2 (F1+2), thrombomodulin (TM) and tissue plasminogen activator antigen (tPA:Ag) prior to G-CSF and immediately before leukapheresis. ADP-induced platelet aggregation studies were also performed. G-CSF administration produced only mild discomfort. We found a significant increase in vWF:Ag (from 0.99 +/- 0.32 U/ml to 1.83 +/- 0.69 U/ml; P < 0.001), in vWF activity (from 1.04 +/- 0.34 U/ml to 1.78 +/- 0.50 U/ml; P < 0.001) and in FVIII:C (from 1.12 +/- 0.37 U/ml to 1.73 +/- 0.57 U/ml; P < 0.001) after G-CSF. Of note, four donors with low baseline vWF had a two- to three-fold increase after receiving G-CSF. G-CSF had no impact on the platelet count, beta-TG, PF-4, GMP-140 or PAC-1. The final% of platelet aggregation decreased from 73 +/- 22% to 37 +/- 26% after G-CSF (P < 0.001). We found a significant decrease in aPTT after G-CSF (29.9 +/- 3.1 s to 28.3 +/- 3.3 s; P = 0.004), but the PT was unaffected. In addition, we also observed a significant increase in TAT, F1+2 and TM, but not in tPA:Ag. Our data suggest that G-CSF may possibly induce a hypercoagulable state by increasing levels of FVIII:C and thrombin generation. In contrast to this information, we found reduced platelet aggregation after G-CSF administration. The clinical implications of these findings remain unclear and larger studies are definitely required. VL - 23 CP - 10 N1 - LeBlanc, R Roy, J Demers, C Vu, L Cantin, G Research Support, Non-U.S. Gov't England Bone marrow transplantation Bone Marrow Transplant. 1999 May;23(10):991-6. ID - 878 ER -