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Bumbăcea RS, Udrea MR, Ali S, Bojincă VC. Balancing Benefits and Risks: A Literature Review on Hypersensitivity Reactions to Human G-CSF (Granulocyte Colony-Stimulating Factor). Int J Mol Sci 2024; 25:4807. [PMID: 38732026 PMCID: PMC11084733 DOI: 10.3390/ijms25094807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/20/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Human granulocyte colony-stimulating factor (G-CSF) is a granulopoietic growth factor used in the treatment of neutropenia following chemotherapy, myeloablative treatment, or healthy donors preparing for allogeneic transplantation. Few hypersensitivity reactions (HRs) have been reported, and its true prevalence is unknown. We aimed to systematically characterize G-CSF-induced HRs while including a comprehensive list of adverse reactions. We reviewed articles published before January 2024 by searching in the PubMed, Embase, Cochrane Library, and Web of Science databases using a combination of the keywords listed, selected the ones needed, and extracted relevant data. The search resulted in 68 entries, 17 relevant to our study and 7 others found from manually searching bibliographic sources. A total of 40 cases of G-CSF-induced HR were described and classified as immediate (29) or delayed (11). Immediate ones were mostly caused by filgrastim (13 minimum), with at least 9 being grade 5 on the WAO anaphylaxis scale. Delayed reactions were mostly maculopapular exanthemas and allowed for the continuation of G-CSF. Reactions after first exposure frequently appeared and were present in at least 11 of the 40 cases. Only five desensitization protocols have been found concerning the topic at hand in the analyzed data. We believe this study brings to light the research interest in this topic that could benefit from further exploration, and propose regular updating to include the most recently published evidence.
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Affiliation(s)
- Roxana Silvia Bumbăcea
- Allergology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.S.B.); (S.A.)
- Department of Allergology and Clinical Immunology, “Carol Davila” Nephrology Clinical Hospital, 010731 Bucharest, Romania
| | - Mihaela Ruxandra Udrea
- Allergology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.S.B.); (S.A.)
- Department of Allergology and Clinical Immunology, “Carol Davila” Nephrology Clinical Hospital, 010731 Bucharest, Romania
| | - Selda Ali
- Allergology Department, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.S.B.); (S.A.)
- Department of Allergology and Clinical Immunology, “Carol Davila” Nephrology Clinical Hospital, 010731 Bucharest, Romania
| | - Violeta Claudia Bojincă
- Clinical Department 5, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Internal Medicine and Rheumatology, “Sfânta Maria” Hospital, 011172 Bucharest, Romania
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Comments on the article "Allogeneic platelet-derived growth factors local injection in treatment of tennis elbow: a prospective randomized controlled study" by Kandil et al. INTERNATIONAL ORTHOPAEDICS 2022; 46:1905-1906. [PMID: 35641791 DOI: 10.1007/s00264-022-05451-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
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Doval D, Choudhary D, Sharma SK, Khandelwal V. Severe hypersensitivity allergic reaction to filgrastim in a healthy stem cell donor. J Oncol Pharm Pract 2019; 25:2056-2058. [PMID: 31203715 DOI: 10.1177/1078155219856419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Granulocyte-colony stimulating factor (G-CSF) has been approved for use for mobilization of hematopoietic progenitor cells from the marrow into the blood for peripheral blood stem cell collection. Commonly reported side effects of G-CSF include deep throbbing bone pain, severe myalgia and leucocytosis. CASE REPORT We describe a case of severe hypersensitivity anaphylactoid reaction after filgrastim administration in a healthy stem cell donor. This haploidentical donor was a 38-year old man with sickle cell trait, donating stem cells for his son, a case of sickle cell disease. On administration of G-CSF (10 µg/kg) he developed features of anaphylaxis. MANAGEMENT AND OUTCOME He was given supportive care with oxygen, IV fluid bolus, anti histaminics and steroids. The donor had complete recovery and underwent successful bone marrow harvest. CONCLUSION There have been various reports of hypersensitivity anaphylactoid reactions in patients undergoing chemotherapy but those associated with the first dose of G-CSF in healthy stem cell donors have rarely been reported.
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Affiliation(s)
- Divya Doval
- Department of Hemato-oncology and BMT, BLK Superspeciality Hospital, New Delhi, India
| | - Dharma Choudhary
- Department of Hemato-oncology and BMT, BLK Superspeciality Hospital, New Delhi, India
| | - Sanjeev K Sharma
- Department of Hemato-oncology and BMT, BLK Superspeciality Hospital, New Delhi, India
| | - Vipin Khandelwal
- Department of Hemato-oncology and BMT, BLK Superspeciality Hospital, New Delhi, India
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Moalic-Allain V. Medical and ethical considerations on hematopoietic stem cells mobilization for healthy donors. Transfus Clin Biol 2018; 25:136-143. [PMID: 29555414 DOI: 10.1016/j.tracli.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/26/2018] [Indexed: 12/19/2022]
Abstract
Hematopoietic stem cell transplantation is a common procedure potentially beneficial to many individuals with cancer, hematological, or inherited disorders, and has highlighted the need of related or unrelated donors to perform allograft. Donation of hematopoietic stem cells, either through bone marrow harvest or peripheral blood stem cell collection, is well-established and widespread. Over the past two decades, the peripheral blood stem cell collection by aphaeresis has become the main source of hematopoietic stem cells for transplantation, due to faster engraftment and practicability and lower risk of relapse for high-risk patients. For peripheral blood stem cell donation, donors require mobilization of hematopoietic stem cells from bone marrow into the blood stream. This is performed by growth factors injections. This article is a review of reported applications of growth factors (original granulocyte colony stimulating factor and its biosimilars), for healthy donors' peripheral blood stem cell mobilization, in terms of toxicity, side effects, efficacy and follow-up. There is still an ethical dilemma for clinicians involved in allograft, because they expose healthy donors to drugs. It is important to dispel some of the critical concerns regarding their use in healthy volunteers, particularly because they receive no personal therapeutic benefit from this procedure.
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Affiliation(s)
- V Moalic-Allain
- Laboratoire de génétique moléculaire et d'histocompatibilité, pôle de pathologie biologie, CHRU Morvan, bâtiment 5 bis, RDC, 2, avenue Foch, 29609 Brest cedex, France.
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Bourgeois M, Sonet A, Botson F, Graux C, Fabry A, André M, Deneys V. Hematopoietic stem cell apheresis in the context of a related allogeneic transplant for acute myeloid leukemia: an unexpected outcome, medical emergency and ethical issue. Haematologica 2017; 102:e115-e116. [PMID: 27927773 PMCID: PMC5394977 DOI: 10.3324/haematol.2016.159285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Marc Bourgeois
- CHU UCL Namur, Université Catholique de Louvain, Department of Hematology, Yvoir, Belgium
| | - Anne Sonet
- CHU UCL Namur, Université Catholique de Louvain, Department of Hematology, Yvoir, Belgium
| | - Françoise Botson
- CHU UCL Namur, Université Catholique de Louvain, HPC Collection Center, Yvoir, Belgium
| | - Carlos Graux
- CHU UCL Namur, Université Catholique de Louvain, Department of Hematology, Yvoir, Belgium
| | - Annick Fabry
- CHU UCL Namur, Université Catholique de Louvain, HPC Collection Center, Yvoir, Belgium
| | - Marc André
- CHU UCL Namur, Université Catholique de Louvain, Department of Hematology, Yvoir, Belgium
| | - Véronique Deneys
- CHU UCL Namur, Université Catholique de Louvain, HPC Collection Center, Yvoir, Belgium
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Yamamoto K, Doki N, Senoo Y, Najima Y, Kobayashi T, Kakihana K, Haraguchi K, Okuyama Y, Sakamaki H, Ohashi K. Severe Hypoxemia in a Healthy Donor for Allogeneic Hematopoietic Stem Cell Transplantation after Only the First Administration of Granulocyte-Colony Stimulating Factor. Transfus Med Hemother 2016; 43:433-435. [PMID: 27994532 DOI: 10.1159/000446814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 02/01/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Granulocyte-colony stimulating factor (G-CSF) is widely used to mobilize peripheral blood stem cells (PBSCs) in healthy donors. A few reports have shown that some healthy donors developed acute respiratory distress syndrome or capillary leak syndrome after more than several rounds of G-CSF administration or leukapheresis. CASE REPORT We report the case of a healthy donor for allogeneic stem cell transplantation who developed severe hypoxemia 1 h after only the first administration of G-CSF. The donor was administered 10 μg/kg G-CSF (lenograstim) subcutaneously for PBSC mobilization. 1 h after the first administration of G-CSF, the donor suddenly presented with dry cough and dyspnea. The oxygen saturation by pulse oximetry (SpO2) in the room air was 88%. An electrocardiogram and chest radiography revealed no abnormalities. We excluded other causes of severe hypoxemia and diagnosed the donor with hypoxemia due to G-CSF administration, which was subsequently terminated. The donor was administered 2 l/min oxygen via a nasal cannula and 100 mg hydrocortisone intravenously. He subsequently recovered, and SpO2 in the room air returned to 98% 10 h after hypoxemia. CONCLUSION These respiratory symptoms might be related to anaphylactoid or hypersensitivity reaction. The donors should be observed for at least 1 h after the first administration of G-CSF.
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Affiliation(s)
- Keita Yamamoto
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yasushi Senoo
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Takeshi Kobayashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kazuhiko Kakihana
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kyoko Haraguchi
- Division of Transfusion and Cell Therapy, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yoshiki Okuyama
- Division of Transfusion and Cell Therapy, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
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Worel N, Buser A, Greinix HT, Hägglund H, Navarro W, Pulsipher MA, Nicoloso de Faveri G, Bengtsson M, Billen A, Espino G, Fechter M, Giudice V, Hölig K, Kanamori H, Kodera Y, Leitner G, Netelenbos T, Niederwieser D, van Walraven SM, Rocha V, Torosian T, Vergueiro C, Weisdorf D, Yabe H, Halter JP. Suitability Criteria for Adult Related Donors: A Consensus Statement from the Worldwide Network for Blood and Marrow Transplantation Standing Committee on Donor Issues. Biol Blood Marrow Transplant 2015; 21:2052-2060. [PMID: 26271194 DOI: 10.1016/j.bbmt.2015.08.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 08/05/2015] [Indexed: 12/20/2022]
Abstract
The number of allogeneic hematopoietic stem cell (HSC) transplants performed globally each year continues to increase. Advances in HLA typing, better supportive care, and administration of reduced-intensity conditioning regimens allow treatment of older patients with older sibling donors. Pretransplant donor assessment and testing are very important processes affecting the quality and safety of donation. For unrelated HSC donors detailed recommendations for health assessment have been published, allowing donation only if they are unrestrictedly healthy. Eligibility criteria for related donors are less strict and vary significantly between centers. In situations where a family donor does not meet the suitability criteria for unrelated donors, involved physicians often struggle with the decision whether the matched relative is suitable for donation or not. On behalf of the Worldwide Network for Blood and Marrow Transplantation Standing Committee on Donor Issues, we intended to develop a consensus document with recommendations for donor workup and final clearance of family donors who would not be able to serve as unrelated donors because of their age or pre-existing diseases. This article covers different topics intending to support decision-making, with the goal of minimizing medical risk to the donor and protection of the recipient from transmissible diseases.
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Affiliation(s)
- Nina Worel
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
| | - Andreas Buser
- Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland; Department of Hematology, University Hospital Basel, Basel, Switzerland
| | | | - Hans Hägglund
- Division of Hematology, Department of Medical Sciences Uppsala University, Uppsala, Sweden
| | | | - Michael A Pulsipher
- Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute/University of Utah, Primary Children's Hospital, Salt Lake City, Utah
| | | | - Mats Bengtsson
- Tobias Registry of Swedish Bone Marrow Donors and Uppsala University, Department of Immunology, Genetics and Pathology, Uppsala, Sweden
| | | | - German Espino
- Department of Internal Medicine, Hematology and Bone Marrow Transplantation Section, University Hospital Caja del Seguro Social, Panama City, Panama
| | - Mirjam Fechter
- Europdonor Foundation Leiden, Leiden University Medical Centre, Leiden, The Netherlands
| | - Valeria Giudice
- Department of Immunohematology and Transfusion Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Kristina Hölig
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Heiwa Kanamori
- Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Yoshihisa Kodera
- Asia-Pacific Blood and Marrow Transplantation Group and Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Gerda Leitner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | - Tanja Netelenbos
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Suzanna M van Walraven
- Europdonor Foundation Leiden, Leiden University Medical Centre, Leiden, The Netherlands; Ethics Working Group of the World Marrow Donor Association, Leiden, The Netherlands
| | - Vanderson Rocha
- Oxford University Hospitals NHS Trust, British Bone Marrow Donor Registry and Cord Blood Banks, NHS-BT, Oxford, United Kingdom
| | | | - Carmen Vergueiro
- FCM Santa Casa de São Paulo, Disciplina de Hematologia e Oncologia, São Paulo, Brasil
| | - Daniel Weisdorf
- Bone Marrow Transplant Program, University of Minnesota, Minneapolis, Minnesota
| | - Hiromasa Yabe
- Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Tokyo, Japan
| | - Jörg P Halter
- Department of Hematology, University Hospital Basel, Basel, Switzerland
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Unrelated adult stem cell donor medical suitability: recommendations from the World Marrow Donor Association Clinical Working Group Committee. Bone Marrow Transplant 2014; 49:880-6. [DOI: 10.1038/bmt.2014.67] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/06/2014] [Accepted: 02/20/2014] [Indexed: 11/08/2022]
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10
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Tholpady A, Chiosea I, Lyons JJ, Baird K, Leitman SF. Systemic hypersensitivity reaction mimicking anaphylaxis after first filgrastim administration in a healthy donor. Transfusion 2013; 53:1146-7. [PMID: 23659534 DOI: 10.1111/trf.12149] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Moalic V. Mobilization and collection of peripheral blood stem cells in healthy donors: Risks, adverse events and follow-up. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.patbio.2012.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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12
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Hematopoietic stem cell donation. Int J Hematol 2013; 97:446-55. [DOI: 10.1007/s12185-013-1298-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
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Lown RN, Shaw BE. 'First do no harm': where do we stand on unrelated hematopoietic cell donor safety? Expert Rev Hematol 2012; 5:249-52. [PMID: 22780204 DOI: 10.1586/ehm.12.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chen SH, Yang SH, Chu SC, Su YC, Chang CY, Chiu YW, Kao RH, Li DK, Yang KL, Wang TF. The role of donor characteristics and post-granulocyte colony-stimulating factor white blood cell counts in predicting the adverse events and yields of stem cell mobilization. Int J Hematol 2011; 93:652-659. [PMID: 21509437 DOI: 10.1007/s12185-011-0844-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 03/29/2011] [Accepted: 03/29/2011] [Indexed: 10/18/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF) is now widely used for stem cell mobilization. We evaluated the role of post-G-CSF white blood cell (WBC) counts and donor factors in predicting adverse events and yields associated with mobilization. WBC counts were determined at baseline, after the third and the fifth dose of G-CSF in 476 healthy donors. Donors with WBC ≥ 50 × 10(3)/μL post the third dose of G-CSF experienced more fatigue, myalgia/arthralgia, and chills, but final post-G-CSF CD34(+) cell counts were similar. Although the final CD34(+) cell count was higher in donors with WBC ≥ 50 × 10(3)/μL post the fifth G-CSF, the incidence of side effects was similar. Females more frequently experienced headache, nausea/anorexia, vomiting, fever, and lower final CD34(+) cell count than did males. Donors with body mass index (BMI) ≥ 25 showed higher incidences of sweat and insomnia as well as higher final CD34(+) cell counts. Donor receiving G-CSF ≥ 10 μg/kg tended to experience bone pain, headache and chills more frequently. Multivariate analysis indicated that female gender is an independent factor predictive of the occurrence of most side effects, except for ECOG > 1 and chills. Higher BMI was also an independent predictor for fatigue, myalgia/arthralgia, and sweat. Higher G-CSF dose was associated with bone pain, while the WBC count post the third G-CSF was associated with fatigue only. In addition, one donor in the study period did not complete the mobilization due to suspected anaphylactoid reaction. Observation for 1 h after the first injection of G-CSF is required to prevent complications from unpredictable side effects.
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Affiliation(s)
- Shu-Huey Chen
- Department of Pediatrics, Tzu-Chi General Hospital, Hualien, Taiwan.,Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.,Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan
| | - Shang-Hsien Yang
- Department of Pediatrics, Tzu-Chi General Hospital, Hualien, Taiwan.,Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Sung-Chao Chu
- Department of Hematology and Oncology, Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, 970, Taiwan
| | - Yu-Chieh Su
- Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.,Department of Hematology and Oncology, Tzu-Chi General Hospital, Chiayi, Taiwan
| | - Chu-Yu Chang
- Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan
| | - Ya-Wen Chiu
- Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan
| | - Ruey-Ho Kao
- Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.,Department of Hematology and Oncology, Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, 970, Taiwan
| | - Dian-Kun Li
- Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.,Department of Hematology and Oncology, Tzu-Chi General Hospital, Chiayi, Taiwan
| | | | - Tso-Fu Wang
- Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan. .,Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan. .,Department of Hematology and Oncology, Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, 970, Taiwan.
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Pulmonary micro-embolism in a healthy donor following G-CSF administration for mobilization of hemopoietic progenitor cells. Bone Marrow Transplant 2011; 47:308-10. [DOI: 10.1038/bmt.2011.72] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Donor safety: the role of the WMDA in ensuring the safety of volunteer unrelated donors: clinical and ethical considerations. Bone Marrow Transplant 2010; 45:832-8. [DOI: 10.1038/bmt.2010.2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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