Spleen enlargement in healthy donors during G-CSF mobilization of PBPCs.
BACKGROUND
Recombinant human G-CSF is widely used to mobilize PBPCs in healthy donors for allogeneic transplantation. There have been concerns about donor safety because of splenic ruptures during G-CSF application. To address this problem, changes in splenic size in 91 healthy donors during G-CSF mobilization of allogeneic PBPCs were investigated.


METHODS
For mobilization, G-CSF in a dosage of 7.5 microg per kg per day was administered for 5 days and PBPC collection started Day 5. Splenic size was determined by ultrasound before G-CSF application was started and on the day of the first apheresis.


RESULTS
The mean increase in splenic length was 11 mm (range, 0-28 mm; p<0.0001), whereas a mean increase of 5 mm in width (range, 0-14 mm; p<0.0001) was measured. No major side effects could be observed. There was no significant correlation between the increase in splenic size and the hematologic values, or the age and body-mass index. In a multivariant analysis, no independent risk factor for the development of a spleen enlargement over 19 mm in length and 9 mm in thickness was found in 20 percent of investigated donors.


CONCLUSIONS
In this prospective trial, a significant spleen enlargement was observed in healthy donors during G-CSF mobilization of allogeneic PBPCs. Further investigations are needed to define the degree of spleen enlargement with higher G-CSF dosages to improve donor safety.
Platzbecker
U
U
Medical Clinic I, the Institute of Transfusion Medicine, the Institute of Radiology, and the Institute of Biometry, University Hospital Carl Gustav Carus, Dresden, Germany. Platzbecker@oncocenter.de
Prange-Krex
G
G
Bornhäuser
M
M
Koch
R
R
Soucek
S
S
Aikele
P
P
Haack
A
A
Haag
C
C
Schuler
U
U
Berndt
A
A
Rutt
C
C
Ehninger
G
G
Hölig
K
K
D001782:Blood Donors; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D011446:Prospective Studies; D013154:Spleen / Q000187:drug effects; D013163:Splenomegaly / Q000097:blood*
D016179:Granulocyte Colony-Stimulating Factor