First step towards Macedonian donor registry-mobilization of HLA-identical familiar healthy stem cell donor in allogeneic transplant setting
Journal
Bone Marrow Transplatation Journal
Date Issued
2011
Author(s)
DOI
10.1038/bmt.2011.48
Abstract
Mobilized peripheral blood stem cells (PBSC) from healthy
donors have become an increasingly used alternative to bone
marrow for allogeneic transplantation. Granulocyte colonystimulating
factor (G-CSF) –primed peripheral stem cells harvesting
may result in a graft with increased mononuclear cells
collected, increased progenitor cell dose and potential for more
rapid engraftment resulting in improved survival. Filgrastrim is
not only known to mobilize CD34+ progenitor cells but acts as a
pleiotropic immune modulator. So, systematic donor follow-up
in healthy donors is needed.
The aim of this study is to evaluate safety and feasibility of
G-CSF primed hematopoietic peripheral stem cells in familiar HLA-identical donors. The follow-up focused on clinical and
laboratory testing including reports of adverse event after the
mobilization.
Granulocyte colony-stimulating factor (G-CSF) is administrated
in 56 healthy donors to reach suffi cient mobilization in
the period 2000-2010. The donors were characterized as follows:
43 years median; female 60% of the donors. G-CSF
was administrated in the dose 10g/kg of donor weight in
fi ve day and PBSC collections started on the fi fth day using
COBE Spectra cell separator. The aim was to collect mononuclear
cells 2x108/kg of recipient weight. Three donors were
mobilized twice (for second transplant). Aphaeresis needed to
reach target number of CD34+ cells were: 1 apherese in 50%,
more than two apherese need in only 1 patient. The most frequent
adverse event that was noted by patients was bone pain
associated with increasing number of white blood cells. Better
mobilization and higher PBSC yield correlated signifi cantly with
younger age. Four years after G-CSF –primed peripheral stem
cells harvesting, a young female 48 years old was diagnosed
with acute myeloblastic leukemia. Four years ago when she
was 44 years old, she donated for her HLA identical sister with
acute myeloblastic leukemia.
G-CSF is safe and very effective for PBSC mobilization in our
group of healthy donors. This method allows certain collections
of suffi cient numbers of progenitors in virtually all healthy
donors. We demonstrated that fi lgrastim mobilization for peripheral
blood stem collection is effective and result with successful
engraftment in all the recipients. Daily injection of 10g/kg of
G-CSF and fi rst aphaeresis preformed at day 5 seems to be the
best strategy to obtain the CD34+ cell count for an allogeneic
hematopoietic stem cell graft.
donors have become an increasingly used alternative to bone
marrow for allogeneic transplantation. Granulocyte colonystimulating
factor (G-CSF) –primed peripheral stem cells harvesting
may result in a graft with increased mononuclear cells
collected, increased progenitor cell dose and potential for more
rapid engraftment resulting in improved survival. Filgrastrim is
not only known to mobilize CD34+ progenitor cells but acts as a
pleiotropic immune modulator. So, systematic donor follow-up
in healthy donors is needed.
The aim of this study is to evaluate safety and feasibility of
G-CSF primed hematopoietic peripheral stem cells in familiar HLA-identical donors. The follow-up focused on clinical and
laboratory testing including reports of adverse event after the
mobilization.
Granulocyte colony-stimulating factor (G-CSF) is administrated
in 56 healthy donors to reach suffi cient mobilization in
the period 2000-2010. The donors were characterized as follows:
43 years median; female 60% of the donors. G-CSF
was administrated in the dose 10g/kg of donor weight in
fi ve day and PBSC collections started on the fi fth day using
COBE Spectra cell separator. The aim was to collect mononuclear
cells 2x108/kg of recipient weight. Three donors were
mobilized twice (for second transplant). Aphaeresis needed to
reach target number of CD34+ cells were: 1 apherese in 50%,
more than two apherese need in only 1 patient. The most frequent
adverse event that was noted by patients was bone pain
associated with increasing number of white blood cells. Better
mobilization and higher PBSC yield correlated signifi cantly with
younger age. Four years after G-CSF –primed peripheral stem
cells harvesting, a young female 48 years old was diagnosed
with acute myeloblastic leukemia. Four years ago when she
was 44 years old, she donated for her HLA identical sister with
acute myeloblastic leukemia.
G-CSF is safe and very effective for PBSC mobilization in our
group of healthy donors. This method allows certain collections
of suffi cient numbers of progenitors in virtually all healthy
donors. We demonstrated that fi lgrastim mobilization for peripheral
blood stem collection is effective and result with successful
engraftment in all the recipients. Daily injection of 10g/kg of
G-CSF and fi rst aphaeresis preformed at day 5 seems to be the
best strategy to obtain the CD34+ cell count for an allogeneic
hematopoietic stem cell graft.
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