A case of acute lung injury in a peripheral blood stem cell donor mobilized with pegylated recombinant human granulocyte colony-stimulating factor

• Published in: International journal of hematology 2024-08, Vol.120 (2), p.262-266
• Main Authors: Liu, Lin, Zhang, Ding-song, Zhang, Xue-juan, Zheng, Zhong-zheng, Wang, San-bin
• Format: Article
• Language: English
• Subjects: Active control; Acute Lung Injury - chemically induced; Acute Lung Injury - etiology; Adult; Blood; Blood Donors; Case Report; Case reports; Collection; Colony-stimulating factor; Dyspnea; Granulocyte colony-stimulating factor; Granulocyte Colony-Stimulating Factor - administration & dosage; Granulocyte Colony-Stimulating Factor - adverse effects; Granulocytes; Heart rate; Hematology; Hematopoietic Stem Cell Mobilization - adverse effects; Hematopoietic Stem Cell Mobilization - methods; Hematopoietic stem cells; Hemoptysis; Humans; Hydration; Hypoxemia; Injuries; Leukocytes; Leukocytes (granulocytic); Leukocytes (neutrophilic); Lungs; Male; Medicine; Medicine & Public Health; Neutrophils; Oncology; Pain; Peripheral blood; Peripheral Blood Stem Cell Transplantation - adverse effects; Peripheral Blood Stem Cells; Polyethylene glycol; Polyethylene Glycols - adverse effects; Recombinant Proteins - administration & dosage; Recombinant Proteins - adverse effects; Recombinant Proteins - therapeutic use; Stem cell transplantation; Stem cells; Tissue Donors; Vital signs
• ISSN: 0925-5710; 1865-3774; 1865-3774
• DOI: 10.1007/s12185-024-03779-z

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.