Low incidence of severe aGVHD and accelerating hemopoietic reconstitution in allo-BMT using lenograstim stimulated BM cells.
OBJECTIVE
To investigate the efficacy of accelerating hemopoietic reconstraction and reducing a graft versus host disease (GVHD) in Allo-BMT receiving lenograstim stimulated donor marrow and to assess the preliminary biological mechanism.


METHODS
The donors for thirty patients (study group) with leukemia were given lenograstim 3-4 micrograms.kg-1.d-1 for seven days prior to marrow harvest. The results of subsequent engraftment in the recipients was compared with fifteen donors without G-CSF (control group). Five donors themselves were studied to assess the effects of lenograstion on hematopoietic progenitor cells and lymphocyte subsets in BM.


RESULTS
The stimulated bone marrow contained a higher number of nucleated cells, CFU-GM and CD34+ cells (P < 0.01). The hematopoetic reconstitution was accelerated. Until granulocyte counts exceeded 0.5 x 10(9)/L and plalete counts exceeded 20 x 10(9)/L, the days were 16.7 +/- 3.2 and 18.4 +/- 3.0 days as compared with those of the control group (22.5 +/- 5.1 and 26.3 +/- 5.9 days respectively, P < 0.01). The incidence of grade II-IV aGVHD was very low, only one case with grade II aGVHD on the skin in the study group. Four out of fifteen patients (26.7%) in the control group had grade II-IV aGVHD (P < 0.05). The number of T lymphocyte subsets in the harvested BM stimulated by G-CSF changed. In comparison with the control group, CD4+ decreased and CD8+ increased significantly (P < 0.01). The changes of progenitor cells and T lymphocyte subsets in BM from pre- to post-G-CSF stimulation indicated that the percentage of CD4+ cells reduced (P < 0.05), that of CD8+ cells, and that of CD34+ increased (P < 0.01). The incidence of chronic GVHD and relapse of leukemia were not different significantly between both groups.


CONCLUSIONS
Allogenic bone marrow transplant (Allo-BMT) donors given G-CSF can accelerate engraftment and minimize the incidence of severe aGVHD. There is a trend in favour of improved transplant-related complications.
Ji
S
S
Research Centre for Hematology, General Air Force Hospital of PLA, Beijing 100036, China.
Chen
H
H
Wang
H
H
Ma
J
J
Pan
S
S
Xue
M
M
Zhu
L
L
Liu
J
J
Xiao
M
M
Zhou
L
L
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D001854:Bone Marrow Cells / Q000166:cytology / Q000187:drug effects* / Q000276:immunology; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D017252:CD3 Complex / Q000032:analysis; D015704:CD4 Antigens / Q000032:analysis; D016827:CD8 Antigens / Q000032:analysis; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology* / Q000473:pathology; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D015994:Incidence; D000078224:Lenograstim; D007938:Leukemia / Q000628:therapy; D008214:Lymphocytes / Q000166:cytology / Q000187:drug effects / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000494:pharmacology*; D016019:Survival Analysis; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data
D018952:Antigens, CD34; D017252:CD3 Complex; D015704:CD4 Antigens; D016827:CD8 Antigens; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000078224:Lenograstim