Single-dose pegfilgrastim for the mobilization of allogeneic CD34+ peripheral blood progenitor cells in healthy family and unrelated donors.
OBJECTIVE
Short-term treatment with granulocyte colony-stimulating factor (G-CSF) has been established as the standard regimen for mobilizing allogeneic peripheral blood progenitor cells (PBPC) from healthy donors. The pegylated form of filgrastim (pegfilgrastim) has a longer elimination half-life because of decreased serum clearance and might be a convenient alternative for stem cell mobilization.


METHODS
Twenty-five family (n=15) or unrelated (n=10) healthy donors received a single-dose of 12 mg pegfilgrastim for mobilization of allogeneic PBPC. Donors with inadequate mobilization (blood CD34+ cells <or=5/microL on day 3 or <or=20/mL on day 4) were given additional daily doses of 10 mg/kg conventional filgrastim. Leukapheresis was planned to start on day 5.


RESULTS
All harvests were completed successfully. In 20 out of 25 donors (80 %) only a single apheresis was necessary. Additional non-pegylated filgrastim had to be given to only one 74-year old family donor. The maximum concentration of circulating CD34+ cells occurred on day 5 (median 67/microL, range 10-385/mL). The median yield of CD34+ cells was 9.3 (range 3.2-39.1)x10(6)/kg of the recipient's body weight. The median number of T cells in the apheresis products was 3.9 (range 2.7-10.8)x10(8)/kg. Bone pain, headaches and transient elevations of alkaline phosphatase and lactate dehydrogenase were the main adverse events.


CONCLUSIONS
The study shows that collection of allogeneic PBPC after administration of a single dose of pegfilgrastim is feasible. The toxicity profile, graft composition and impact on the recipients' outcome need further investigation.
Kroschinsky
Frank
F
University Hospital Dresden, 1st Medical Department, Dresden, Germany. kroschinsky@mk1.med.tu-dresden.de
Hölig
Kristina
K
Poppe-Thiede
Kirsten
K
Zimmer
Kristin
K
Ordemann
Rainer
R
Blechschmidt
Matthias
M
Oelschlaegel
Uta
U
Bornhauser
Martin
M
Rall
Gabi
G
Rutt
Claudia
C
Ehninger
Gerhard
G
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D004341:Drug Evaluation; D005260:Female; D000069585:Filgrastim; D005434:Flow Cytometry; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000494:pharmacology*; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D007937:Leukapheresis; D007958:Leukocyte Count; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects / Q000378:metabolism; D010146:Pain / Q000139:chemically induced; D010147:Pain Measurement; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012189:Retrospective Studies; D013163:Splenomegaly / Q000139:chemically induced; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism; D014184:Transplantation, Homologous / Q000009:adverse effects
D018952:Antigens, CD34; D011994:Recombinant Proteins; D016753:Interleukin-10; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim