Use of G-CSF in matched sibling donor pediatric allogeneic transplantation: a consensus statement from the Children's Oncology Group (COG) Transplant Discipline Committee and Pediatric Blood and Marrow Transplant Consortium (PBMTC) Executive Committee.
Preliminary studies indicate that G-CSF-primed marrow harvesting may result in a graft with increased mononuclear cells collected, increased CD34(+) stem and progenitor cell dose and a potential for more rapid engraftment. Increased cell dose plus other potential positive effects of G-CSF priming have resulted in improved survival in non-randomized preliminary studies. These benefits may be available without the increased risk of chronic graft versus host disease (GVHD) that is experienced with allogeneic peripheral blood stem cell (PBSC) transplant. A phase III Children's Oncology Group (COG)/Pediatric Blood and Marrow Transplant Consortium (PBMTC) trial comparing G-CSF-primed marrow to standard marrow has been proposed. This document reviews background studies of G-CSF-primed marrow and addresses benefits and risks of G-CSF administration to normal pediatric donors. We conclude that the approach is promising and warrants further study. Risks of G-CSF to the donor are minimal and benefits to both donor and recipient may occur.
Grupp
Stephan A
SA
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. grupp@email.chop.edu
Frangoul
Haydar
H
Wall
Donna
D
Pulsipher
Michael A
MA
Levine
John E
JE
Schultz
Kirk R
KR
D002648:Child; D032921:Consensus; D006086:Graft vs Host Disease / Q000188:drug therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000494:pharmacology; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D036102:Peripheral Blood Stem Cell Transplantation / Q000941:ethics / Q000379:methods* / Q000592:standards*; D018570:Risk Assessment; D035781:Siblings; D014019:Tissue Donors / Q000941:ethics; D014184:Transplantation, Homologous
D016179:Granulocyte Colony-Stimulating Factor