title: The role of donor characteristics and post-granulocyte colony-stimulating factor white blood cell counts in predicting the adverse events and yields of stem cell mobilization.
abstract: Granulocyte colony-stimulating factor (G-CSF) is now widely used for stem cell mobilization. We evaluated the role of post-G-CSF white blood cell (WBC) counts and donor factors in predicting adverse events and yields associated with mobilization. WBC counts were determined at baseline, after the third and the fifth dose of G-CSF in 476 healthy donors. Donors with WBC ≥ 50 × 10(3)/μL post the third dose of G-CSF experienced more fatigue, myalgia/arthralgia, and chills, but final post-G-CSF CD34(+) cell counts were similar. Although the final CD34(+) cell count was higher in donors with WBC ≥ 50 × 10(3)/μL post the fifth G-CSF, the incidence of side effects was similar. Females more frequently experienced headache, nausea/anorexia, vomiting, fever, and lower final CD34(+) cell count than did males. Donors with body mass index (BMI) ≥ 25 showed higher incidences of sweat and insomnia as well as higher final CD34(+) cell counts. Donor receiving G-CSF ≥ 10 μg/kg tended to experience bone pain, headache and chills more frequently. Multivariate analysis indicated that female gender is an independent factor predictive of the occurrence of most side effects, except for ECOG > 1 and chills. Higher BMI was also an independent predictor for fatigue, myalgia/arthralgia, and sweat. Higher G-CSF dose was associated with bone pain, while the WBC count post the third G-CSF was associated with fatigue only. In addition, one donor in the study period did not complete the mobilization due to suspected anaphylactoid reaction. Observation for 1 h after the first injection of G-CSF is required to prevent complications from unpredictable side effects.
authors.affiliation: Department of Pediatrics, Tzu-Chi General Hospital, Hualien, Taiwan.|Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.|Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan.
authors.forename: Shu-Huey
authors.initials: SH
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, Tzu-Chi General Hospital, Hualien, Taiwan.|Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.
authors.forename: Shang-Hsien
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Department of Hematology and Oncology, Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, 970, Taiwan.
authors.forename: Sung-Chao
authors.initials: SC
authors.lastname: Chu
authors.affiliation: Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.|Department of Hematology and Oncology, Tzu-Chi General Hospital, Chiayi, Taiwan.
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Su
authors.affiliation: Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan.
authors.forename: Chu-Yu
authors.initials: CY
authors.lastname: Chang
authors.affiliation: Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan.
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Chiu
authors.affiliation: Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.|Department of Hematology and Oncology, Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, 970, Taiwan.
authors.forename: Ruey-Ho
authors.initials: RH
authors.lastname: Kao
authors.affiliation: Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan.|Department of Hematology and Oncology, Tzu-Chi General Hospital, Chiayi, Taiwan.
authors.forename: Dian-Kun
authors.initials: DK
authors.lastname: Li
authors.affiliation: Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan.
authors.forename: Kuo-Liang
authors.initials: KL
authors.lastname: Yang
authors.affiliation: Department of Medicine, College of Medicine, Tzu-Chi University, Hualien, Taiwan. tfwang@tzuchi.com.tw.|Buddhist Tzu-Chi Stem Cells Center, Hualien, Taiwan. tfwang@tzuchi.com.tw.|Department of Hematology and Oncology, Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, 970, Taiwan. tfwang@tzuchi.com.tw.
authors.forename: Tso-Fu
authors.initials: TF
authors.lastname: Wang
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000097:blood*; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects; D006261:Headache / Q000139:chemically induced; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects; D006412:Hematopoietic Stem Cells / Q000166:cytology* / Q000378:metabolism; D006801:Humans; D007937:Leukapheresis; D007958:Leukocyte Count; D007962:Leukocytes / Q000166:cytology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010146:Pain / Q000139:chemically induced; D036102:Peripheral Blood Stem Cell Transplantation; D011994:Recombinant Proteins; D012189:Retrospective Studies; D013624:Taiwan; D014019:Tissue Donors; D014839:Vomiting / Q000139:chemically induced
chemical_list: D018952:Antigens, CD34; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor