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Published online before print September 22, 2008

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© by The Society for Leukocyte Biology
Journal of Leukocyte Biology, doi:10.1189/jlb.0608388

Received for publication June 28, 2008.
Revised June 28, 2008.
Accepted for publication August 8, 2008.

Article

Lithium and hematology: established and proposed uses

Daniele Focosi ^*@, Antonio Azzarà ^*, Richard Eric Kast , Giovanni Carulli ^*, and Mario Petrini ^*

*Division of Hematology, Azienda Ospedaliera Santa Chiara, University of Pisa, Pisa, Italy; and Department of Psychiatry, University of Vermont, Burlington, Vermont, USA

^@ To whom correspondence should be addressed. E-mail: dfocosi{at}tin.it.

	Abstract

Lithium (as lithium carbonate) is an unexpensive drug, widely used in psychiatry for over 50 years in treatment of mood instability (bipolar disorder) and as an adjunct to antidepressants. Hematological effects of neutrophilia and increased circulating CD34⁺ cells of marrow origin have long been known. Lithium was at the center of hematological investigations in the 1980s, but no definitive use in hematology has yet emerged. We review evidence that lithium increases G-CSF and augments G-CSF effects. We suggest possible therapeutic uses of lithium in neutropenia. In bone marrow transplantation, preharvest lithium-assisted hematopoietic stem cell mobilization may be useful as well.

Key Words: stem cell mobilization • stem cell transplantation • engraftment • CD34 • neutropenia