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Severe allergic reaction with anaphylaxis to G-CSF (lenograstim) in a healthy donor

Bone Marrow Transplantation volume 44, pages 129–130 (2009)Cite this article

Haemopoietic growth factors such as G-CSF have been widely used to stimulate granulocyte production in neutropenic patients. Various studies have looked at the potential side effects of G-CSF and found it to have a good safety profile.1, 2 Most commonly, G-CSF is used to prevent or shorten the period of neutropenia secondary to chemotherapy. It acts by supporting the proliferation, differentiation and activation of committed progenitor cells of the granulocyte series. G-CSF is also extensively used to mobilize into the peripheral blood haemopoietic stem cells from healthy sibling or volunteer unrelated donors. Currently, two forms of recombinant human G-CSF are available for this purpose: both of these are licensed in the UK for use in healthy donors. Lenograstim is a Chinese hamster ovary-derived G-CSF consisting of 174 amino acids with 4% carbohydrate, indistinguishable from native G-CSF. Filgrastim is an Escherichia coli-derived G-CSF, differing from lenograstim in being non-glycosylated and in having an extra methionine group at the N-terminal end of the peptide chain.

We describe a case of a severe allergic reaction with anaphylaxis to lenograstim (Granocyte, Chugai Pharma, London, UK) in a healthy volunteer unrelated donor. The donor was a 26-year-old man, with a history of mild asthma but no known drug allergies. He was not taking any regular medications for his asthma. He was physically active, with no other medical history. After being selected as an HLA match for a patient in need of an unrelated donor haemopoietic stem cell transplant, the volunteer donor underwent a full medical assessment including a chest X-ray, and was deemed medically fit to undergo the PBSC collection.

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Authors and Affiliations

  1. The Anthony Nolan Trust, The Royal Free Hospital, London, UK

    S Tulpule, B E Shaw, P Makoni, A-M Little, J A Madrigal & J M Goldman

  2. Section of Haemato-oncology, Royal Marsden Hospital, London, UK

    B E Shaw

  3. Department of Haematology, Imperial College, London, UK

    J M Goldman

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  1. S Tulpule
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  2. B E Shaw
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  3. P Makoni
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  4. A-M Little
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  5. J A Madrigal
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  6. J M Goldman
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Correspondence to J M Goldman.

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Tulpule, S., Shaw, B., Makoni, P. et al. Severe allergic reaction with anaphylaxis to G-CSF (lenograstim) in a healthy donor. Bone Marrow Transplant 44, 129–130 (2009). https://doi.org/10.1038/bmt.2008.438

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