粒细胞集落刺激因子动员外周血干细胞富集致肺损伤1例

Granulocyte-colony stimulating factor related lung injury in a leukemia patient during mobilization of peripheral blood stem cells

背景:使用粒细胞集落刺激因子动员外周血干细胞后导致急性肺损伤仅有零星报道,机制尚不清楚。目的:探讨应用重组人粒细胞集落刺激因子动员外周血干细胞富集导致肺损伤的临床表现、机制。方法:报告1例粒细胞集落刺激因子动员外周血干细胞时导致咯血和影像学肺部结节状、片状阴影,并复习相关文献。结果与结论:粒细胞集落刺激因子可能会导致肺损伤,机制可能和中性粒细胞在肺部聚集、黏附、释放炎症递质有关。

BACKGROUND：There are few studies about granulocyte-colony stimulating factor related lung injury during mobilization of peripheral blood stem cells,but the mechanism is unclear.OBJECTIVE：To explore the clinical manifestation and possible pathogenic mechanism of acute lung injury related to recombinant human granulocyte-colony stimulating factor.METHODS：We reported a case of sudden hemoptysis,scattered lung nodular shadows and patchy shadows in a leukemia patient following the administration of granulocyte-colony stimulating factor to mobilize peripheral blood stem cells,and related literatures were also reviewed.RESULTS AND CONCLUSION：Granulocyte-colony stimulating factor while mobilizing peripheral blood stem cells could induce acute lung injury,which may involve migration of neutrophils to vascular spaces,adhesion of neutrophils to endothelial cells,and potentiation of proinflammatory cytokine expression.