[Clinical study of single-dose G-CSF in mobilization and reconstruction of allogeneic peripheral blood stem cell transplantation].
OBJECTIVE
Mobilization of hematopoietic stem cells from healthy donors by stimulators such as granulocyte colony stimulating factor (G-CSF) in allogeneic peripheral blood stem cell transplantation (allo- PBSCT) is increasingly used clinically; however, the mechanism, the dose, and the schedule are not fully understood. This study was designed to evaluate the effectiveness and safety of single daily dose of 250 microg G-CSF (Lenograstim) for stem cell mobilization and hematopoietic reconstitution after allo-PBSCT.


METHODS
The study included a group of 38 consecutive patients with hematological malignancies (acute leukemia:21 cases; chronic myelogenous leukemia:14 cases; myelodysplastic syndrome:3 cases) from January 2000 to June 2002. For the 38 sibling or matched unrelated donors G-CSF was administered at single daily dose of 250 microg despite of their body weight. Leukapheresis was performed on the fifth day. The patients were conditioned with total body irradiation (TBI)+cyclophosphamide or busulfan+cyclophosphamide. G-CSF support was given from the third day after stem cell reinfusion, usually until neutrophil recovery.


RESULTS
The average dosage of G-CSF administrated was 4.8 microg x (kg x d)(-1). An average of 1.7 times of apheresis were performed. The median CD34(+) cell and CD34(+)/CD38(-) cell yield were 6.09 x 10(6)/kg and 1.33 x 10(6)/kg, respectively. The CD4(+)/CD8(+) ratio of the leukapheresis products was 1.41+/-0.51,and (17.61+/-6.64)% of the leukapheresis products were CD3(-)/CD16(+)CD56(+) cells. G-CSF was used after reinfusion for the median time of 9 days. The median time for WBC >1 x 10(9)/L, ANC >0.5 x 10(9)/L,and PLT >20 x 10(9)/L were 11,11,and 12 days, respectively. One patient died of severe infection on the fifth day after transplantation, while all the other patients achieved hematopoietic reconstitution satisfyingly.


CONCLUSIONS
The administration of G-CSF in the single dose fashion in allo-PBSCT has a good effect in the mobilization of PBSC with minor side effects, and it can markedly promote hematopoietic reconstitution after transplantation.
Tian
Hong
H
Peripheral Blood Stem Cell Transplantation Workgroup of Guangdong, First Military Medical University, Guangzhou, Guangdong, PR China.
Zhou
Shu-Yun
SY
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000494:pharmacology; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects; D006412:Hematopoietic Stem Cells / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D000078224:Lenograstim; D007938:Leukemia / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology*; D014184:Transplantation, Homologous / Q000009:adverse effects
D000276:Adjuvants, Immunologic; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000078224:Lenograstim