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. 2022 Aug;37(4):354-359.
doi: 10.1002/jca.21979. Epub 2022 Mar 18.

Increased serum pro-B-type natriuretic peptide in hematopoietic progenitor cell donors stimulated with G-CSF

Leonard N Chen  1 , Celina Montemayor-Garcia  2 , Kamille A West-Mitchell  1 , Cathy C Cantilena  1
Affiliations

Increased serum pro-B-type natriuretic peptide in hematopoietic progenitor cell donors stimulated with G-CSF

Leonard N Chen et al. J Clin Apher. 2022 Aug.

Abstract

Hematopoietic stem cells (HPCs) donors mobilized by granulocyte-colony-stimulating factor (G-CSF) can develop various signs and symptoms. proBNP (pro-B-type natriuretic peptide) is a serum marker of heart failure. A donor who developed severe adverse reactions after G-CSF mobilization was found to have high serum proBNP levels. We followed additional donors who received identical mobilization regimen to investigate the prevalence of this phenomenon. Eighteen healthy donors underwent a mobilization regimen of 10 μg/Kg G-CSF daily for 5 days prior to allogeneic HPC collection using Spectra Optia between January 2016 and February 2017 were included in this study. Serum proBNP levels were measured before and after G-CSF stimulation and immediately after apheresis. Apheresis collection parameters and other laboratory results were also reviewed. The majority of donors (86.7%) had post-G-CSF elevation of serum proBNP. Seven of those had elevated proBNP above upper normal range (124 pg/ml). The subgroup of donors with normal proBNP is younger (median age of 37 vs 42 years), with majority being male (90.9% vs 28.6%) and with smaller processed blood volume (2.2 vs 3 × total blood volume). This case series demonstrates an increase of serum proBNP can be common in HPC donors stimulated with 5 days of 10 mcg/kg G-CSF. This is an adverse reaction that has not been described before. The temporary elevation of proBNP in these donors is not associated with ventricular dysfunction of the heart. The risk factors for marked elevation of proBNP post-G-CSF should be further investigated.

Keywords: G-CSF; apheresis; hematopoietic progenitor cells; hematopoietic stem cell transplantation; pro B-type natriuretic peptide.

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Conflict of interest statement

Disclosure:

Leonard N. Chen declares no conflict of interest

Celina Montemayor-Garcia declares no conflict of interest

Kamille A. West declares no conflict of interest

Cathy C. Cantilena declares no conflict of interest

Figures

Figure 1.
Figure 1.
(A) Serum BNP levels over time. (B) Individual donor’s serum BNP levels over time.
Figure 2.
Figure 2.
Post-apheresis serum BNP levels in relationship to fold of processed volume to total blood volume.
See this image and copyright information in PMC

Comment in

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