Can G-CSF cause leukemia in hematopoietic stem cell donors?

Area of Science:

• Hematology
• Oncology
• Transplantation Science

Background:

• Allogeneic hematopoietic stem cell donations frequently utilize granulocyte-colony stimulating factor (G-CSF).
• G-CSF administration has been linked to myelodysplastic syndromes/acute myelogenous leukemia (MDS/AML) in certain clinical settings.
• Existing clinical data lack sufficient quality to definitively rule out long-term MDS/AML risks in G-CSF mobilized stem cell donors.

Purpose of the Study:

• To evaluate the potential long-term risk of myelodysplastic syndromes/acute myelogenous leukemia (MDS/AML) in donors mobilized with granulocyte-colony stimulating factor (G-CSF).
• To inform clinical practice regarding donor safety and informed consent procedures for allogeneic hematopoietic stem cell donation.

Main Methods:

• Review and analysis of existing clinical data on G-CSF mobilized stem cell donors.
• Assessment of the quality and limitations of current data regarding long-term outcomes.

Main Results:

• No increased incidence of MDS/AML has been identified in G-CSF mobilized donors based on available data.
• The current evidence is insufficient to exclude a potential long-term risk of MDS/AML in this donor population.

Conclusions:

• Physicians should counsel potential stem cell donors about the theoretical long-term risks associated with G-CSF mobilization.
• Offering autologous bone marrow donation as an alternative may be appropriate for some donors, pending further risk assessment.