@article {878,
	title = {A prospective study of G-CSF effects on hemostasis in allogeneic blood stem cell donors},
	journal = {Bone Marrow Transplant},
	volume = {23},
	year = {1999},
	note = {LeBlanc, R Roy, J Demers, C Vu, L Cantin, G Research Support, Non-U.S. Gov{\textquoteright}t England Bone marrow transplantation Bone Marrow Transplant. 1999 May;23(10):991-6.},
	month = {May},
	pages = {991 - 6},
	edition = {36329},
	abstract = {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.},
	keywords = {*Tissue Donors, Adult, Blood Coagulation Disorders / chemically induced, Cohort Studies, Factor VIII / metabolism, Female, Filgrastim / administration \& dosage / *adverse effects, Hematopoietic Stem Cell Mobilization / *adverse effects, Hematopoietic Stem Cell Transplantation, Hemostasis / *drug effects, Humans, Male, Middle Aged, Platelet Aggregation / drug effects, Prospective Studies, Thrombin / biosynthesis, Transplantation, Homologous, von Willebrand Factor / metabolism},
	issn = {0268-3369 (Print) 0268-3369 (Linking)},
	doi = {10.1038/sj.bmt.1701756},
	author = {LeBlanc,R. and Roy,J. and Demers,C. and Vu,L. and Cantin,G.}
}
