Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Miscellaneous Complications

Adverse side-effects associated with G-CSF in patients with chronic myeloid leukemia undergoing allogeneic peripheral blood stem cell transplantation

Abstract

Administration of the myeloid growth factor G-CSF after allogeneic hematopoietic stem cell transplantation is usually well tolerated, and associated with rapid hematopoietic engraftment. We report a high incidence (50%) of side-effects associated with post-transplant G-CSF in patients with chronic phase chronic myeloid leukemia undergoing allogeneic HLA-identical sibling peripheral blood stem cell transplantation. One or more of the following signs and symptoms were observed shortly after the subcutaneous injection of G-CSF: dyspnea, chest pain, nausea, hypoxemia, diaphoresis, anaphylaxis, syncope and flushing. These reactions led to discontinuation of G-CSF in the majority of patients. Predictive factors could not be identified, and the underlying mechanism leading to these reactions is unknown. Bone Marrow Transplantation (2000) 25, 1197–1201.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Schmitz N, Linch DC, Dreger P et al. Randomized trial of filgrastim-mobilized peripheral blood progenitor cell transplantation versus autologous bone marrow transplantation in lymphoma patients Lancet 1996 347: 353–357

    Article  CAS  Google Scholar 

  2. Hartmann O, Le Corroler AG, Blaise D et al. Peripheral blood stem cell and bone marrow transplantation for solid tumors and lymphomas: hematologic recovery and costs Ann Intern Med 1997 126: 600–607

    Article  CAS  Google Scholar 

  3. Ottinger HD, Beelen DW, Scheulen B et al. Improved immune reconstitution after allo-transplantation of peripheral blood stem cells instead of bone marrow Blood 1996 88: 2775–2779

    CAS  PubMed  Google Scholar 

  4. Powles R, Smith C, Milan S et al. Human recombinant GM-CSF in allogeneic bone-marrow transplantation for leukaemia: double blind, placebo-controlled trial Lancet 1990 336: 1417–1420

    Article  CAS  Google Scholar 

  5. De Witte T, Gratwohl A, Van Der Lely N et al. Recombinant human granulocyte-macrophage colony-stimulating factor accelerates neutrophil and monocyte recovery after allogeneic T-cell-depleted bone marrow transplantation Blood 1992 79: 1359

    CAS  PubMed  Google Scholar 

  6. Nemunaitis J, Rosenfeld C, Ash R et al. Phase III double-blind trial of recombinant human granulocyte–macrophage colony-stimulating factor following after allogeneic bone marrow transplantation Bone Marrow Transplant 1995 15: 949–954

    CAS  PubMed  Google Scholar 

  7. Schriber RS, Chao NJ, Long GD et al. G-CSF after allogeneic bone marrow transplantation Blood 1994 84: 1680–1684

    CAS  PubMed  Google Scholar 

  8. Masoaka T, Takaku F, Kato S et al. Recombinant human granulocyte colony-stimulating in allogeneic bone marrow transplantation Exp Hematol 1989 17: 1047–1050

    Google Scholar 

  9. Schuening FG, Lilleby K, Clift RA et al. Phase I study of rhG-CSF after marrow transplantation from HLA-identical siblings Blood 1993 82: 349a

    Google Scholar 

  10. Asano S, Masaoka T, Takaku F . Beneficial effect of rhG-CSF in marrow transplanted patients: results of multicenter phase II–III studies Transplant Proc 1991 23: 1701–1703

    CAS  PubMed  Google Scholar 

  11. Linch DC, Scarffe H, Proctor S et al. Randomized vehicle-controlled dose-finding study of glycosylated rhG-CSF after bone marrow transplantation Bone Marrow Transplant 1993 11: 307–311

    CAS  PubMed  Google Scholar 

  12. American Society of Clinical Oncology . American Society of Clinical Oncology recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines J Clin Oncol 1994 12: 2471–2508

    Article  Google Scholar 

  13. Anderlini P, Przepiorka D, Seong D et al. Clinical toxicity and laboratory effects of granulocyte colony-stimulating factor mobilization and blood cell apheresis from normal donors, and analysis of charges for the procedure Transfusion 1996 36: 590–595

    Article  CAS  Google Scholar 

  14. Jayesimi I, Giralt SS, Wood J . Subcutaneous granulocyte colony-stimulating factor and acute anaphylaxis New Engl J Med 1991 325: 587–588

    Google Scholar 

  15. Adkins D . Anaphylactoid reaction in a normal donor given granulocyte colony-stimulating factor J Clin Oncol 1998 16: 812–813

    Article  CAS  Google Scholar 

  16. Khoury H, Adkins D, Pence H et al. Low transplant-related acute complications in patients with CML undergoing allogeneic stem cell transplantation with a low dose (550 cGy) total body irradiation (TBI) conditioning regimen Blood 1999 94: 393a

    Google Scholar 

  17. Adkins D, Pence H, Brown R et al. Low-dose (550 cGy) total body irradiation given in a single dose results in consistent, durable engraftment of related donor peripheral blood stem cells, with a low 100 day treatment-related mortality of 9% Blood 1999 94: 711a

    Google Scholar 

  18. Emanuel PD, Bates LJ, Castelberry RP et al. Selective hypersensitivity to granulocyte–macrophage colony-stimulating factor by juvenile chronic myeloid leukemia hematopoietic progenitors Blood 1991 77: 925–929

    CAS  PubMed  Google Scholar 

  19. Schmitz N, Dreger P, Suttorp M et al. Primary transplantation of allogeneic peripheral blood progenitor cells mobilized with filgrastim (G-CSF) Blood 1995 85: 1666–1672

    CAS  PubMed  Google Scholar 

  20. Bensinger WI, Weaver CH, Appelbaum FR et al. Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor Blood 1995 85: 1655–1658

    CAS  PubMed  Google Scholar 

  21. Bensinger WI, Clift R, Martin P et al. Allogeneic peripheral blood stem cell transplantation in patients with advanced hematologic malignancies: a retrospective comparison with marrow transplantation Blood 1996 88: 2794–2800

    CAS  PubMed  Google Scholar 

  22. Elmaagacli AH, Beelen DW, Opalka B et al. The risk of molecular and cytogenetic disease in patients with Philadelphia chromosome positive first chronic phase chronic myeloid leukemia is reduced after transplantation of allogeneic peripheral blood stem cells compared to marrow Blood 1999 94: 384–389

    CAS  PubMed  Google Scholar 

  23. Przepiorka D, Anderlini P, Ippoliti C et al. Allogeneic blood stem cell transplantation in advanced hematologic cancers Bone Marrow Transplant 1997 19: 455–460

    Article  CAS  Google Scholar 

  24. Archimbaud E, Michallet M, Philip I et al. G-CSF given in addition to interferon alfa to mobilize peripheral blood stem cells for autologous transplantation in CML Br J Haematol 1997 99: 678–684

    Article  CAS  Google Scholar 

  25. Carreras E, Sierra J, Rovira M et al. Successful autografting in CML using Philadelphia negative progenitor cells mobilized with rHuG-CSF alone in a patient responding to alfa-interferon Br J Haematol 1997 96: 421–423

    Article  CAS  Google Scholar 

  26. Antin JH, Ferrara JL . Cytokine dysregulation and acute GVHD Blood 1992 80: 2964–2968

    CAS  PubMed  Google Scholar 

  27. Baiocchi G, Scambia G, Benedetti P et al. Autologous stem cell transplantation: sequential production of hemopoietic cytokines underlying granulocyte recovery Cancer Res 1993 53: 1297–1303

    CAS  PubMed  Google Scholar 

  28. Saitoh H, Shibata A . Levels of serum G-CSF in patients with chronic myeloid leukemia Leuk Lymphoma 1993 11: 443–446

    Article  CAS  Google Scholar 

  29. Busch FW, Pilgrim TB, Kramer A et al. Plasma levels of G-CSF in patients after allogeneic bone marrow transplantation for chronic myeloid leukemia correlate with engraftment of transplanted marrow Bone Marrow Transplant 1997 19: 653–659

    Article  CAS  Google Scholar 

  30. Ozcan M, Beksac M . Is there a relationship between G-CSF response to conditioning regimen and engraftment after bone marrow transplantation? Bone Marrow Transplant 1998 21: 533–535

    Article  CAS  Google Scholar 

  31. Yamaguchi M, Hirai K, Morita Y et al. Hemopoietic growth factors regulate the survival of human basophils in vitro Int Arch Allergy Immunol 1992 97: 322–329

    Article  CAS  Google Scholar 

  32. Pedersen M, Kristensen KS, Clementsen P et al. Increased numbers of circulating basophils with decreased releasability after administration of rhG-CSF to allergic patients Agents Actions 1994 41: C24–25

    Article  Google Scholar 

  33. Fuguda T, Kakihara T, Ohnishi Y et al. Neoplastic basophil/mast cell precursors from CML display heterogeneous responses for a hematopoietic factor Leukemia Res 1992 16: 197–204

    Article  Google Scholar 

  34. Devereaux S, Linch DC, Costa D et al. Transient leucopenia induced by granulocyte–macrophage colony-stimulating factor Lancet 1987 2: 1523–1524

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Khoury, H., Adkins, D., Brown, R. et al. Adverse side-effects associated with G-CSF in patients with chronic myeloid leukemia undergoing allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 25, 1197–1201 (2000). https://doi.org/10.1038/sj.bmt.1702423

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702423

Keywords

This article is cited by

Search

Quick links