Granulocyte colony-stimulating factor alone at 20 micrograms/kg vs. 10 micrograms/kg for peripheral blood stem cell mobilization in children.
Mobilization of peripheral blood stem cells (PBSC) by granulocyte colony-stimulating factor (G-CSF), at 10 micrograms/kg/day vs. 20 micrograms/kg/day (in 42 and 29 patients, respectively), was compared in children with solid tumors or leukemias. During mobilization, differences were noted in the peak values of CD34+ cells in peripheral blood (PB) in these two groups (median 28 x 10(6)/L for 10 micrograms/kg/day vs. 61 x 10(6)/L for 20 micrograms/kg/day; p = 0.025). Similar numbers of progenitor cells were harvested for the two concentrations of G-CSF. However, similar CD34+ cell levels in the leukapheresis product were obtained after only the third dose of G-CSF at 20 micrograms/kg/day compared with the fourth dose of G-CSF at 10 micrograms/kg/day (1.7 and 1.2 x 10(6) CD34+ cells/kg/one patient's blood volume processed, respectively). Of note is the impact of diagnosis on PB CD34+ cell levels. We conclude that, in children, mobilization with G-CSF at 20 micrograms/kg/day could minimize the duration of priming but not reduce the number of leukaphereses. Thus, the impact on outcome, clinical practice, bed utilization, and health economics is uncertain.
Halle
P
P
Unité Bioclinique de Prélèvement et Traitement des Cellules Hématopoiétiques, Hotel Dieu, C.H.U. Clermont-Ferrand, France.
Kanold
J
J
Rapatel
C
C
Boiret
N
N
Berger
M
M
Stephan
J L
JL
Albuisson
E
E
Tournilhac
O
O
Bonhomme
J
J
Deméocq
F
F
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007223:Infant; D007937:Leukapheresis / Q000379:methods; D007938:Leukemia / Q000628:therapy; D009369:Neoplasms / Q000628:therapy
D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor