Journal of Clinical Oncology, Vol 15, 1601-1607, Copyright © 1997 by American Society of Clinical Oncology
Allogeneic-blood stem-cell collection following mobilization with low- dose granulocyte colony-stimulating factor
MR Bishop, SR Tarantolo, JD Jackson, JR Anderson, K Schmit-Pokorny, D Zacharias, ZS Pavletic, SJ Pirruccello, JM Vose, PJ Bierman, PI Warkentin, JO Armitage and A Kessinger
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330, USA. MRBishop@mail.UNMC.edu
PURPOSE: The optimal dose of granulocyte colony-stimulating factor (G- CSF)
for mobilization of allogeneic-blood stem cells (AlloBSC) has yet to be
determined. As part of a prospective trial, 41 related human leukocyte
antigen (HLA)-matched donors had blood cells mobilized with G- CSF at 5
micrograms/kg/d by subcutaneous administration. The purpose of this trial
was to monitor adverse effects during G-CSF administration and stem-cell
collection, to determine the optimal timing for stem-cell collection, and
to determine the cellular composition of stem-cell products following G-CSF
administration. PATIENTS AND METHODS: The median donor age was 42 years.
Apheresis began on day 4 of G-CSF administration. At least three daily 12-L
apheresis collections were performed on each donor. A minimum of 1.0 x
10(6) CD34+ cells/kg (recipient weight) and 8.0 x 10(8) mononuclear
cells/kg were collected from each donor. All collections were cryopreserved
in 5% dimethyl sulfoxide and 6% hydroxyethyl starch. RESULTS: Toxicities
associated with G-CSF administration and the apheresis process included
myalgias/arthralgias (83%), headache (44%), fever (27%), and chills (22%).
The median baseline platelet count of 242 x 10(4)/ mL decreased to 221,
155, and 119 x 10(6)/mL on days 4, 5, and 6 of G-CSF administration,
respectively. Median numbers of CD34+ cells in collections 1, 2, and 3 were
1.99, 2.52, and 3.13 x 10(6)/kg, respectively. The percentage and total
number of CD4+, CD8+, and CD56+/CD3- cells remained relatively constant
during the three collections. Median total numbers of cells were as
follows: CD34+, 7.73 x 10(6)/kg; and lymphocytes, 6.93 x 10(8)/kg.
CONCLUSION: Relatively low doses of G-CSF can mobilize sufficient numbers
of AlloBSC safely and efficiently.
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