Use of G-CSF to mobilise PBSC in normal healthy donors--an international survey.
A questionnaire was mailed to a senior haematologist in each of 31 countries to investigate the current use of G-CSF for PBSC mobilisation in normal healthy donors. The questions related to the regulatory status of G-CSF, its use in the related and unrelated donor settings, whether a national standardised protocol had been developed, which routes of vascular access were permitted, whether self-administration of G-CSF was allowed, strategies for monitoring long-term after-effects of the use of G-CSF and the approximate numbers of donors who had received G-CSF in each country during 1996. Responses were received from 28 countries. Clinicians in all 28 countries are administering G-CSF to related donors, and in nine countries also to unrelated donors; the situation vis-à-vis unrelated donors is under review in another 11 countries. Responses indicate that approval for the use of G-CSF has come mainly through local research ethics committees. Of those countries permitting the use of G-CSF in the unrelated donor setting, six permit it for second donations, two for both first and second donations, and one in a limited trial situation only. In just one of these nine countries has a national standardised protocol been developed. Self-administration of G-CSF by donors is allowed in 18/27 countries. Venous access is restricted to peripheral veins in 10/28 countries, the remaining 18 permit central venous access if peripheral access fails. Regarding the number of normal donors receiving G-CSF during 1996, Germany, Israel, Italy and Spain report more than 100 each, Canada, The Netherlands, South Africa, and the UK report in the range 31-100, and the remaining responding countries each report under 30 donors. Methods for long-term follow-up vary considerably from country to country and involve questionnaires and/or medical examinations, with less than half the responders specifying the need for laboratory investigations.
Anthony Nolan Bone Marrow Trust, The Royal Free Hospital, Hampstead, London, UK.
S A
SA
Cleaver
J M
JM
Goldman
D001782:Blood Donors; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D019538:Health Care Surveys; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous
D016179:Granulocyte Colony-Stimulating Factor