Evaluation and comparison of three mobilization methods for the collection of granulocytes.
BACKGROUND
Cancer chemotherapeutic regimens have become more potent and myeloablative. As a consequence, morbidity and mortality due to opportunistic infections have become a major challenge. The provision of adequate doses of viable granulocytes has thus become an important approach for circumventing the problem. A schedule for collecting therapeutic numbers of cells with minimal donor toxicity has yet to be established.


METHODS
An investigation of three mobilization schedules for the collection of granulocytes for transfusion--granulocyte-colony-stimulating factor (G-CSF) 5 micrograms per kg daily; G-CSF 5 micrograms per kg every other day, and prednisone 60 mg given orally (20 mg doses at 17 hours, 12 hours, and 2 hours before the collection).


RESULTS
A total of 464 apheresis procedures involving 163 healthy donors were analyzed. Prednisone caused a small increase in the white cell (WBC) counts over the collection days, while G-CSF every other day and daily schedules improved WBC counts to 145 and 160 percent, respectively (p = 0.004). Similarly, administration of G-CSF daily and every other day mobilized higher yields of granulocytes over the collection days, compared to the prednisone schedule (170% and 180% vs. 105%; p = 0.02).


CONCLUSIONS
Compared with prednisone, higher WBC yields were achieved by G-CSF stimulation; G-CSF given every other day is as effective as daily G-CSF administration for the recruitment of granulocytes, which makes the mobilization procedure more cost-effective.
Jendiroba
D B
DB
Department of Leukemia, University of Texas M. D. Anderson Cancer Center, Houston, USA.
Lichtiger
B
B
Anaissie
E
E
Reddy
V
V
O'Brien
S
S
Kantarjian
H
H
Freireich
E J
EJ
D000284:Administration, Oral; D004334:Drug Administration Schedule; D005069:Evaluation Studies as Topic; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects; D006098:Granulocytes / Q000166:cytology* / Q000637:transplantation; D006400:Hematocrit; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D007958:Leukocyte Count / Q000187:drug effects; D017708:Leukocyte Transfusion; D008297:Male; D009504:Neutrophils / Q000187:drug effects; D010976:Platelet Count; D011241:Prednisone / Q000008:administration & dosage* / Q000009:adverse effects
D016179:Granulocyte Colony-Stimulating Factor; D011241:Prednisone