The role of donor characteristics and post-granulocyte colony-stimulating factor white blood cell counts in predicting the adverse events and yields of stem cell mobilization

Abstract

Granulocyte colony-stimulating factor (G-CSF) is now widely used for stem cell mobilization. We evaluated the role of post-G-CSF white blood cell (WBC) counts and donor factors in predicting adverse events and yields associated with mobilization. WBC counts were determined at baseline, after the third and the fifth dose of G-CSF in 476 healthy donors. Donors with WBC ≥ 50 × 10(3)/μL post the third dose of G-CSF experienced more fatigue, myalgia/arthralgia, and chills, but final post-G-CSF CD34(+) cell counts were similar. Although the final CD34(+) cell count was higher in donors with WBC ≥ 50 × 10(3)/μL post the fifth G-CSF, the incidence of side effects was similar. Females more frequently experienced headache, nausea/anorexia, vomiting, fever, and lower final CD34(+) cell count than did males. Donors with body mass index (BMI) ≥ 25 showed higher incidences of sweat and insomnia as well as higher final CD34(+) cell counts. Donor receiving G-CSF ≥ 10 μg/kg tended to experience bone pain, headache and chills more frequently. Multivariate analysis indicated that female gender is an independent factor predictive of the occurrence of most side effects, except for ECOG > 1 and chills. Higher BMI was also an independent predictor for fatigue, myalgia/arthralgia, and sweat. Higher G-CSF dose was associated with bone pain, while the WBC count post the third G-CSF was associated with fatigue only. In addition, one donor in the study period did not complete the mobilization due to suspected anaphylactoid reaction. Observation for 1 h after the first injection of G-CSF is required to prevent complications from unpredictable side effects.

A review of the haematopoietic stem cell donation experience: is there room for improvement?

“…[7][8][9][10]17,41,[49][50][51] Women are also more likely to experience serious complications 11,50 and are almost twice as likely to require extended hospitalization. 7,8 The explanation for Female gender More likely to require extended hospitalization following donation.…”

“…11,50 PBSC and BM Higher incidence of most apheresis-related ARs. 7,8,10,519,14,51 PBSC More likely to require a line. 8 PBSC More fatigue following donation (likely due to higher relative blood volume depletion).…”

“…9 PBSC Older donors more likely to experience citrate-related toxicity 50 PBSC No influence on ARs. 10,51 PBSC Older donors reported somewhat less difficulty with donation. 49 BM…”

“…Common side effects of PBSC donation are summarized in Table 1. [5][6][7][8][9][10][11][12][13][14] Other complications can be related to the insertion of a catheter and the process of leukapheresis. The latter might cause symptomatic hypovolemia, and hypocalcaemia is common as a result of the use of citrate anticoagulation in the circuit.…”

Predonation Health-Related Quality of Life Scores Predict Time to Recovery in Hematopoietic Stem Cell Donors

“…Common side effects of BM and PBSC donation are well known [1][2][3][4][5][6], although studies examining which groups of donors are at increased risk are limited [3,[5][6][7][8][9][10][11][12][13]. The latter is important because strategies to enhance donor safety should be based on findings from these studies and could result in a more personalized approach to higher risk groups.…”