The determinants of granulocyte yield in 1198 granulocyte concentrates collected from unrelated volunteer donors mobilized with dexamethasone and granulocyte-colony-stimulating factor: a 13-year experience.
BACKGROUND
The combination of granulocyte-colony-stimulating factor (G-CSF [filgrastim]) and dexamethasone (G-CSF/dex) is an effective granulocyte mobilization regimen, but the variables that affect donor neutrophil response and granulocyte collection yield are not well characterized.


METHODS
A computerized database containing records of 1198 granulocyte collections from 137 unrelated volunteer apheresis donors during a 13-year period was retrospectively analyzed. Donors were categorized by age, sex, and cumulative number of granulocyte donations. Complete blood counts at baseline and after G-CSF/dex stimulation were recorded. The outcome variables include the preprocedure absolute neutrophil count (preANC), which reflects G-CSF/dex stimulation, and the granulocyte product yield per liter processed (BagGranYield/L).


RESULTS
Higher baseline ANC and platelet (PLT) counts were significantly associated with higher preANC while a larger number of prior granulocytapheresis procedures was associated with lower preANC. Total filgrastim dose (used in weight-based dosing) did not significantly impact preANC or the granulocyte yield; weight-based dosing at 5 microg per kg and a uniform 480-microg dose produced equivalent preANC. PreANC and weight were the key determinants of granulocyte yield (BagGranYield/L).


CONCLUSIONS
Apheresis donors with higher baseline PLT counts and ANCs have higher ANCs after G-CSF/dex stimulation; donor age, weight, and sex do not have a significant impact. A uniform G-CSF dose of 480 microg is as effective as weight-based dosing at 5 microg per kg. Donor ANC monitoring should be considered after serial granulocytapheresis procedures.
Quillen
Karen
K
Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA. kq@bu.edu
Yau
Yu Ying
YY
Leitman
Susan F
SF
D000328:Adult; D000368:Aged; D001782:Blood Donors; D001792:Blood Platelets / Q000166:cytology; D002469:Cell Separation / Q000379:methods*; D003907:Dexamethasone / Q000494:pharmacology*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D006098:Granulocytes / Q000166:cytology* / Q000187:drug effects*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D016179:Granulocyte Colony-Stimulating Factor; D003907:Dexamethasone