Influence of filgrastim mobilization of HLA identical familiar healthy stem cell donor in allogenic transplant setting
Journal
Bone Marrow Transplatation Journal
Date Issued
2010
Author(s)
Milenkov, Vlado
DOI
10.1038/bmt.2010.41
Abstract
Mobilized peripheral blood stem cells (PBSC) have become
an increasingly used alternative to bone marrow for allogeneic
transplantation. Granulocyte colony-stimulating 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 laboratory testing
including reports of adverse event.
Granulocyte colony-stimulating factor (G-CSF) is administrated
in 49 healthy donors to reach suffi cient mobilization in the period
2000–2009. The donors were characterized as follows: 43 years
median; female 60% of the donors. G-CSF was administrated in
the dose 10 μg/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 2 × 108/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 GCSF
–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
healthy donors. This method allows certain collections of suffi
cient numbers of progenitors in virtually all 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 10 μg/kg of G-CSF and fi rst
aphaeresis preformed at day 5 seems to be the best strategy to
obtain the CD34 + cell count required for an allogeneic hematopoietic
stem cell graft.
an increasingly used alternative to bone marrow for allogeneic
transplantation. Granulocyte colony-stimulating 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 laboratory testing
including reports of adverse event.
Granulocyte colony-stimulating factor (G-CSF) is administrated
in 49 healthy donors to reach suffi cient mobilization in the period
2000–2009. The donors were characterized as follows: 43 years
median; female 60% of the donors. G-CSF was administrated in
the dose 10 μg/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 2 × 108/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 GCSF
–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
healthy donors. This method allows certain collections of suffi
cient numbers of progenitors in virtually all 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 10 μg/kg of G-CSF and fi rst
aphaeresis preformed at day 5 seems to be the best strategy to
obtain the CD34 + cell count required for an allogeneic hematopoietic
stem cell graft.
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