Duration of filgrastim mobilization and apheresis yield of CD34<sup>+</sup> progenitor cells and lymphoid subsets in normal donors for allogeneic transplantation

Anderlini, Paolo; Przepiorka, Donna; Huh, Yang O.; Lauppe, J.; Miller, P.; Sundberg, J.; Seong, D.; Champlin, Richard E.; Körbling, Martin

doi:10.1046/j.1365-2141.1996.d01-1747.x

Cited by 39 publications

(25 citation statements)

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“…The second course of filgrastim treatment resulted in similar mobilization of CD34 þ progenitor cells and apheresis yield as the initial collection from the same donors. The fact that in some cases leukapheresis was performed after different durations of filgrastim administration may have confounded the picture to some degree, as the duration of filgrastim mobilization can have a significant impact on the apheresis yield (Anderlini et al, 1996a). In at least some of the cases, a sizeable difference in the apheresis yield between the two collections was probably accounted for by a different duration of filgrastim mobilization (i.e.…”

Section: Discussionmentioning

confidence: 99%

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Peripheral blood stem cell apheresis in normal donors: feasibility and yield of second collections

et al. 1997

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Summary. We report 13 normal peripheral blood stem cell (PBSC) donors who had a second PBSC collection for allogeneic transplantation performed after the first. The median interval between the first and second collection was 5 months. Mobilization was achieved with filgrastim (12 mg/ kg/d). No significant difference was found in the median pre-apheresis leucocyte count (×10 9 /l) between the two donations (40 . 2 v 38 . 5; P ¼ 0 : 91). The median apheresis yield (×10 6 CD34 þ cells/litre blood processed, first apheresis) was also similar (28 v 27 . 3; P ¼ 0 : 91). Filgrastim-related adverse events were comparable. These data suggest that second PBSC collections are feasible, similarly tolerated and provide comparable apheresis yields.Keywords: peripheral blood stem cell(s), filgrastim, normal donors, allogeneic blood stem cell transplantation.G-CSF-mobilized peripheral blood stem cells (PBSCs) are increasingly viewed as a promising alternative to marrow for allografting in patients with haematological malignancies (Goldman, 1995;Russell et al, 1996;Lane, 1996). The avoidance of general anaesthesia or invasive procedures, as well as blood transfusions (Anderlini et al, 1996c;Russell et al, 1996;Dreger et al, 1994), makes this approach particularly attractive for repeated PBSC collections, which may be required to treat post-transplant relapse or graft failure. It is unclear whether second PBSC collections (particularly if performed soon after the first) are associated with similar apheresis yields or whether G-CSF exposure impacts the subsequent PBSC mobilization efficiency. Available literature on allogeneic PBSC transplantation (Goldman, 1995;Russell et al, 1996;Lane, 1996) has not addressed this issue. At our institution we have had now the opportunity to perform a sizeable number of second PBSC collections. We therefore reviewed our donor database to report our experience. DONORS AND METHODS Normal apheresis donors.We retrospectively reviewed our PBSC donor database during a 18-month period ( January 1995/June 1996. During this time a total of 181 donors underwent PBSC collections after filgrastim mobilization for allografting in HLA-compatible related patients with haematological malignancies. 16 of them (9%) donated a second time at least 4 weeks after the first. In two of them the exact number of CD34 þ cells in the apheresis product could not be determined because of complex manipulations performed immediately after collection, and the apheresis charts of one donor were not available for review. These donors were considered inevaluable. The others (n ¼ 13) were included in the study. The protocol for PBSC collection was approved by the Institutional Review Board and written informed consent was obtained from each donor.Mobilization and apheresis. PBSC donors received daily filgrastim (6 mg/kg subcutaneously every 12 h) followed by daily continuous-flow leukapheresis through a bilateral peripheral venous access generally beginning on day 4 or day 5 of filgrastim administration. The amount of blood to be p...

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Section: Discussionmentioning

confidence: 99%

“…In the other cases, leukapheresis was started on different days (n ¼ 3) or this information was not available (n ¼ 5). The day 4 and day 5 schedules were evaluated as part of a study (Anderlini et al, 1996a).…”

Section: Resultsmentioning

confidence: 99%

Peripheral blood stem cell apheresis in normal donors: feasibility and yield of second collections

et al. 1997

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“…Thereafter, a decrease of circulating CFU-GM and CD34þ cells was noted, even though G-CSF administration had been continued [10,11]. The highest peak occurs on day 5, but to avoid prolonged exposure to G-CSF some investigators start collection on day 4, however, comparative analysis showed a higher cell yield for the day 5 collection: in a study from the MD Anderson Hospital leukapheresis on day 5 resulted in a higher CD34þ cell harvest compared to apheresis on day 4 after G-CSF stimulation ð7:8 vs 4:9 £ 10 6 CD34 þ cells=kg; p ¼ 0:01Þ [12]. Therefore, on day 5 the optimal time for stem cell collection in healthy donors is after starting G-CSF administration.…”

Section: Timing Of Leukapheresis After G-csf Administrationmentioning

confidence: 97%

Dose and Schedule Effect of G-GSF for Stem Cell Mobilization in Healthy Donors for Allogeneic Transplantation

Zander

2002

Leukemia & Lymphoma

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In the present review, we analyze the literature regarding the dose and schedule effects of granulocyte stimulating factor (G-CSF) for stem cell mobilization of healthy donors for allogeneic stem cell transplantation. There is now evidence for a dose and schedule dependency of G-CSF in mobilizing peripheral blood progenitor cells (PBSC) in healthy donors for allogeneic stem cell transplantation. In general, a dose between 10 and 16 microg/kg split into two doses is recommended. Leukapheresis should be performed on day 4 or 5. A higher dose of G-CSF might be appropriate in donors with low CD34+ baseline cell count (< 2000/ml) or if a high CD34+ cell number is required. However, a higher dose of G-CSF results in a higher acute toxicity like bone and muscle pain or headache. Severe adverse events like thromboembolic events, cerebrovascular incidents, anaphylactoid reactions and an atraumatic splenic rupture have been rarely reported. A prolonged follow-up of the donors is needed to rule out late toxicity of the donors.

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“…[5][6][7] To avoid prolonged exposure to G-CSF other investigators started collection on day 4, but comparative analysis showed a higher cell yield for the day 5 collection. 26,27 A higher CD34 + cell yield can also be achieved by large volume apheresis, processing three to four times the total donor body weight per apheresis. 28 In summary, our study confirmed a dose-dependency of G-CSF when applied for mobilisation of peripheral blood progenitor cells.…”

Section: Discussionmentioning

confidence: 99%

Stem cell mobilisation with 16 μg/kg vs 10 μg/kg of G-CSF for allogeneic transplantation in healthy donors

Kröger

Renges

Sonnenberg

et al. 2002

Bone Marrow Transplant

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Summary:We compared two doses of recombinant human granulocyte-stimulating factor (G-CSF) for stem cell mobilisation in 90 healthy donors for allogeneic stem cell transplantation in a retrospective analysis. Group I (n = 46) received 10 g/kg G-CSF (filgrastim) given as 5 g/kg twice daily, and group II (n = 44) received 16 g/kg, given as 8 g/kg twice daily with a 12-h interval. The groups were well-balanced for age and bodyweight. G-CSF application was performed on an outpatient basis, and leukapheresis was started in all donors on day 5. The most frequent side-effects of G-CSF were grade I/II, bone pain, headache and fatigue in both groups, whereas grade III of bone pain, headache and fatigue occurred in the 2 ؋ 8 g/kg group only. One serious non-fatal event with non-traumatic spleen rupture occurred in the 2 ؋ 5 g/kg group. The CD34 + cell count in the first apheresis of all donors was 5.1 ؋ 10 6 /kg donor weight (range, 1.5-19.3). The CD34 + cell harvest was higher in the 2 ؋ 8 g/kg group than in the 2 ؋ 5 g/kg group (7.1 ؋ 10 6 /kg vs 4.9 ؋ 10 6 /kg; P = 0.09). The target of collecting Ͼ5.0 ؋ 10 6 CD34 + cells/kg donor weight with one apheresis procedure was achieved in 45% of group I and in 61% of group II, respectively. Administering G-CSF at a dosage of 8 g/kg twice daily leads to a higher CD34 + cell yield than a dosage of 2 ؋ 5 g/kg, but is associated with increased toxicity and higher cost.

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Duration of filgrastim mobilization and apheresis yield of CD34⁺ progenitor cells and lymphoid subsets in normal donors for allogeneic transplantation

Cited by 39 publications

References 6 publications

Peripheral blood stem cell apheresis in normal donors: feasibility and yield of second collections

Peripheral blood stem cell apheresis in normal donors: feasibility and yield of second collections

Dose and Schedule Effect of G-GSF for Stem Cell Mobilization in Healthy Donors for Allogeneic Transplantation

Stem cell mobilisation with 16 μg/kg vs 10 μg/kg of G-CSF for allogeneic transplantation in healthy donors

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Duration of filgrastim mobilization and apheresis yield of CD34+ progenitor cells and lymphoid subsets in normal donors for allogeneic transplantation

Cited by 39 publications

References 6 publications

Peripheral blood stem cell apheresis in normal donors: feasibility and yield of second collections

Peripheral blood stem cell apheresis in normal donors: feasibility and yield of second collections

Dose and Schedule Effect of G-GSF for Stem Cell Mobilization in Healthy Donors for Allogeneic Transplantation

Stem cell mobilisation with 16 μg/kg vs 10 μg/kg of G-CSF for allogeneic transplantation in healthy donors

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Duration of filgrastim mobilization and apheresis yield of CD34⁺ progenitor cells and lymphoid subsets in normal donors for allogeneic transplantation