Older age but not donor health impairs allogeneic granulocyte colony-stimulating factor (G-CSF) peripheral blood stem cell mobilization.
We evaluated stem cell mobilization in 195 consecutive sibling donors who underwent a uniform mobilization regimen of granulocyte colony-stimulating factor (G-CSF) at 10 microg/kg/day divided into twice daily dosing. On day 5, peripheral blood (PB) CD34 cells/microL were measured immediately prior to peripheral blood stem cell (PBSC) apheresis. Failed mobilization was defined as <20 CD34 cells/microL on day 5. The median age was 52 years and 73 (37%) were 55 years or greater. Comorbid conditions by the Charlson Comorbidity Index (CCI) occurred in 13%, but only 3% had Karnofsky performance status (PS) <100%. Eight (4%) failed mobilization, defined as <20 CD34 cells/microL on day 5. Older age was associated with fewer CD34 cells/microL (P=.002). In addition, 6/73 (8.2%) older donors failed mobilization compared to 2/122 (1.6%) younger donors (P=.054). Comorbidity, sex, race, and donor weight did not influence mobilization. Although low PS was very uncommon, it was associated with reduced mobilization (P=.021), but not mobilization failure. A small fraction of older donors mobilize poorly, and this is not explained by standard measures of comorbidity or PS.
Richa
Elie
E
Biological Sciences Division, Department of Pathology, Section of Hematology-Oncology, University of Chicago Medical Center, Chicago IL, USA. elie.richa@uchospitals.edu
Papari
Mona
M
Allen
JoAnn
J
Martinez
Guadalupe
G
Wickrema
Amittha
A
Anastasi
John
J
Van Besien
Koen
K
Artz
Andrew
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001772:Blood Cell Count; D001835:Body Weight; D015897:Comorbidity; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology*; D006304:Health Status; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D011994:Recombinant Proteins; D035781:Siblings; D014184:Transplantation, Homologous; D055815:Young Adult
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim