The Effect of a Single or Double Dose of Dexamethasone on Granulocyte Collection with the Continuous Flow Centrifuge

Abstract

A total of 33 leukaphereses were performed with the IBM continuous flow centrifuge on 28 normal healthy donors for the purpose of obtaining increased yields of granulocytes for infusion into leukopenic recipients. The pretreatment of donors within a 10- to 12-hour period prior to pheresis with a double dose of dexamethasone and the addition of hydroxyethyl starch to the input line of the continuous flow centrifuge, significantly increased the total quantity and efficiency of granulocyte collected as compared to a donor group receiving a single dose of dexamethasone in addition to hydroxyethyl starch. A mean of 25.5 x 10^9 total granulocytes were collected in addition to an efficiency of 2.11 x 10^9 granulocytes harvested per liter of blood processed in the doubledose- treated donors, in contrast to 19.6 x 10^9 total granulocytes collected and an efficiency of 1.82 x 10^9 granulocytes harvested per liter of blood processed in the single dose donor group. The results of the present study demonstrate that elevated quantities of granulocytes can be collected from normal donors by scheduling a double dose of dexamethasone prior to the pheresis procedure.

Blood center perspective of granulocyte transfusions: Future applications

“…Stimulation of donors with corticosteroids, prednisone, or dexamethasone has been standard procedure for neutrophil collection. Various dosing schedules have been described [10][11][12]. These approaches usually result in a doubling or tripling of the donor's neutrophil count with a corresponding increase in the collection yield.…”

Serial granulocytapheresisunder daily administration of rHuG–CSF: effects on peripheral blood counts, collection efficiency, and yield

“…The successful use of granulocyte transfusions has been limited for years, however, by the inability to collect sufficient numbers of granulocytes from healthy donors 10,14 . The development of new‐generation blood cell separators (e.g., continuous collection), the use of sedimenting agents (e.g., hydroxyethyl starch [HES]), and the administration of corticosteroids as precollection treatment for donors permitted the collection of about 1 × 10 10 absolute neutrophils per unit 15,16 . There is evidence that only the precollection donor treatment with rHuG–CSF, a potent stimulating agent for myeloid progenitor cells, permits the harvest of the threshold dose of 4 × 10 10 absolute neutrophils 17,19 …”

Effects of granulocyte–colony‐stimulating factor on potential normal granulocyte donors

“…The combination of these two strategies made it possible to collect approximately 1 × 10 10 granulocytes from normal donors. 1–12 However, this is a relatively small dose of granulocytes, because even under normal stable conditions this represents approximately 10 percent of the granulocytes that are produced daily in the average adult. During the 1980s, substantial improvements were made in the management of neutropenic patients, and this improved care, along with the only marginally adequate dose of granulocytes obtained from normal donors, led to a decline in the use of granulocyte transfusions 13 …”