Outcomes of 167 healthy sibling donors after peripheral blood stem cell mobilization with G-CSF 16μg/kg/day: efficacy and safety

Abstract

Mobilization of peripheral blood stem cells (PBSC) using the granulocyte colony-stimulating factor (G-CSF) has enabled the collection even from older donors and those with comorbidities. Several clinical parameters have been reported to predict the success of PBSC mobilization.The aim of our study was to evaluate the safety of PBSC donation in a cohort of 167 sibling donors after mobilization with G-CSF 16 μg/kg/day for 5 days during short-and long term follow-up and to analyse the efficacy, toxicity and factors influencing CD34+ mobilization capacity.All 167 sibling donors completed the established mobilization protocol. The median yield was 7.9x10 6 CD34 cells/kg per recipient weight. The optimal target dose of CD34 cells ≥ 4.0x10 6 /kg was achieved in 140 donors (84%). Only in 4 donors (2%) was the CD34+ yield < 2x10 6 /kg. No major toxicities occured. Factors associated with higher PBSC yields included age < 55 years (p= 0.001), male gender (p= 0.004), preapheresis CD34 cell counts > 51/μL (p < 0.001) and preapheresis leukocyte counts > 45.5 x 10 9 /L (p = 0.003). Comorbidity score, performance status and donor weight did not significantly influence PBSC yields. Long-term follow-up was possible in 60% (101/167) of the donors. The median length of follow-up from PBSC donation was 11.9 years. Most of these donors reported good or very good general health (91%), and no hematological malignancies were observed.The mobilization of PBSC in sibling donors with G-CSF 16 μg/kg/day is an effective and safe procedure with no significant short-and long-term toxicities.

Peripheral Blood Stem Cell Mobilization in Healthy Donors by Granulocyte Colony-Stimulating Factor Causes Preferential Mobilization of Lymphocyte Subsets

“…Treatment with granulocyte colony-stimulating factor (G-CSF) is commonly used for mobilization of peripheral blood stem cells in healthy donors ( 11 , 12 ). G-CSF has several immunomodulatory effects, and for a detailed discussion and additional references we refer to a recent review ( 13 ).…”

Related Pediatric Donors – hematopoietic stem cell collection

“…13 Although several studies in adult donors have not demonstrated any increased long-term complications such as increased cancer risk after short-term G-CSF administration for PBSC, sufficient long-term studies in children addressing this issue have not been performed. [14][15][16] The procedure of PBSC collection in children has the potential of causing pain related to G-CSF administration (site of administration and/or bone pain), the risks associated with central venous catheter (CVC) placement, the occurrence of hypocalcemia during apheresis, and the risk of cardiovascular complications related to hypovolemia. In addition, children with less than 20kg may be exposed to heterologous red blood cells to prime an apheresis circuit of the machine.…”

Equine Dental Pulp Connective Tissue Particles Reduced Lameness in Horses in a Controlled Clinical Trial

“…Minimally manipulated tissue processing results in a characterized product, that is available as an “off-the-shelf” cell and matrix product for easy use in practice and avoids some of the limitations with currently reported tissue sources. These limitations for current sources, that are either not a limitation or much reduced limitation for dental pulp, include, for differentiated tissue such as skin and blood, low stem cell yields that often require extraction (34, 35) or mobilization (36), respectively. Umbilical cord and amnion can be contaminated at birth increasing the potential risk of infection in the stem cell harvests.…”