ECTS2014 Poster Presentations Cancer and bone: basic, translational and clinical (11 abstracts)
The effect of granulocyte colony-stimulating factor in adults undergoing autologous peripheral blood stem cell collection
Karin Amrein 1 , Camilla Drexler 2 , Susanna Oczko 2 , Nazanin Sareban 2 , Sabine Sipurzynski 2 , Thomas R. Pieber 1 , Gerhard Lanzer 2 , Doris Wagner 3 & Astrid Fahrleitner-Pammer 1
1Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University, Graz, Austria; 2Medical University, University Clinic of Blood Group Serology and Transfusion Medicine, Graz, Austria; 3Department of Surgery, Medical University, Graz, Austria.
Introduction: Granulocyte colony-stimulating factor (G-CSF) is widely used to mobilize peripheral blood stem cells (PBSC) and enable PBSC collection by apheresis. Although bone pain is a common adverse event following G-CSF treatment, little is known on its effect on bone metabolism.
Methods: Markers of bone turnover (OC, osteocalcin, β-CTx, bALP, C-terminal telopeptide of type I collagen, bone specific alkaline phosphatase, TRAP, tartrate resistant acid phosphatase) and mineral metabolism were assessed in adult patients with haematological malignancy who received G-CSF for autologous PBSC collection. Analyses were repeated after G-CSF stimulation. Patients with glomerular filtration rate <30 ml/min were excluded from analysis.
Results: Eighteen subjects were included (ten men, eight women, mean age 48±11 years, BMI 24.5±2.9 kg/m2). ß-CTX and bALP were elevated already at baseline. OC, bALP and TRAP were significantly altered by G-CSF, while ß-CTX and calcium levels remained unchanged (
| Biochemical marker, reference range | Before G-CSF | After G-CSF | P |
| β-CTx, 0.06–0.35 ng/ml | 0.40±0.34 | 0.42±0.32 | 0.57 |
| Osteocalcin, 1.0–35.0 ng/ml | 25.3±18.7 | 16.5±10.0 | 0.007 |
| bALP, 7.5–20.6 U/l | 22.8±17.7 | 33.7±17.9 | 0.002 |
| TRAP, 2.59–4.03 μg/l | 3.41±1.57 | 2.78±1.15 | 0.002 |
| Total calcium, 2.25–2.65 mmol/l | 2.30±0.14 | 2.31±0.19 | 0.88 |
Conclusion: Our results demonstrate that high-dose G-CSF acutely affects bone metabolism. The clinical relevance of these finding remains unclear, but further research is warranted to confirm our findings and ascertain long-term skeletal health in this vulnerable population.
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