Mobilization effects of G-CSF, GM-CSF, and darbepoetin-alpha for allogeneic peripheral blood stem cell transplantation.
The effects of GM-/G-CSF and darbepoetin-alpha on stem cell mobilization were investigated. From February 2005 to March 2007, 30 allogeneic sibling donors were randomly assigned to a G-CSF group (5 microg/kg/day for 5-7 days) or triple group (GM-CSF 10 microg/kg/day on 1st and 2nd day, G-CSF 5 microg/kg/day for 5-7 days, and darbepoetin-alpha 40 mg on 1st day). The MNCs and CD34(+) cells were not different between the two groups, although the doses (x10(8)/kg of recipient body weight) of CD3(+) cells (3.64 +/- 1.75 vs. 2.63 +/- 1.36, P = 0.089) and CD8(+) cells (1.07 +/- 0.53 vs. 0.60 +/- 0.30, P = 0.006) were lower in the triple group. The engraftments, frequency of RBC transfusions, and hemoglobin recovery were not different between the two groups. The cumulative incidence of overall and Grades II-IV aGVHD was 64.3% vs. 61.1% and 25.9% vs. 27.1% in the G-CSF and triple regimen group, respectively, whereas the cumulative incidence of cGVHD was 20.8 +/- 1.3% and 24.4 +/- 1.7%, respectively. In conclusion, the triple regimen did not seem to be superior to G-CSF alone in terms of the CD34+ cell dose, hemoglobin recovery, and GVHD. However, the CD8+ cell count was significantly lower in the triple regimen group. The role of a lower CD8+ cell count in the graft may need to be elucidated in the future.
Kim
Shi Nae
SN
Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Republic of Korea.
Moon
Joon Ho
JH
Kim
Jong Gwang
JG
Chae
Yee Soo
YS
Cho
Yoon Young
YY
Lee
Soo Jung
SJ
Kim
Yun Jeong
YJ
Lee
Yoo Jin
YJ
Suh
Jang Soo
JS
Lee
Kun Soo
KS
Sohn
Sang Kyun
SK
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000068256:Darbepoetin alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage*; D006397:Hematinics / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D000078224:Lenograstim; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D011994:Recombinant Proteins / Q000008:administration & dosage; D020127:Recovery of Function; D013234:Stem Cells / Q000166:cytology*; D014184:Transplantation, Homologous
D000276:Adjuvants, Immunologic; D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor; D000068256:Darbepoetin alfa; C081222:sargramostim; D000078224:Lenograstim; D016178:Granulocyte-Macrophage Colony-Stimulating Factor