title: Lenograstim with or without dexamethasone for neutrophil mobilization in healthy donors: short-term kinetics of white blood cells and effects of granulocyte apheresis.
abstract: OBJECTIVE
  To determine the optimal time schedule for neutrophil collection after single mobilization with glycosylated recombinant granulocyte colony-stimulating factor (G-CSF, lenograstim) with or without dexamethasone (DXM).
  
  
  METHODS
  In this prospective randomized trial, 26 healthy volunteers were randomly assigned to a single subcutaneous dose of lenograstim 6 μg/kg plus 8-mg DXM (G-CSF/DXM, n = 13) or placebo (G-CSF/placebo, n = 13). Hematological and biochemical parameters were analyzed before and 12, 15, 18, 21, 24, 27, 29, 36, 48, 60, 72, and 84 h and 7 and 30 days after mobilization. Six G-CSF/DXM subjects underwent standard neutrophil apheresis (NA) 12 and 36 h after mobilization.
  
  
  RESULTS
  Polymorphonuclear neutrophil (PMN) counts 12 and 21 h after mobilization were 22.7 (16.6-32.8) × 10(9) /L and 22.4 (18.6-30.6) × 10(9) /L for G-CSF/placebo versus 33.1 (24.2-44.9) × 10(9) /L and 32.5 (17.4-39.6) × 10(9) /L for G-CSF/DXM. This mobilization plateau was followed by slow normalization at 72-84 h. The six NA subjects had median PMN yields of 62 (47-101) × 10(9) and 39 (23-42) × 10(9) per therapeutic unit. After the first apheresis, PMN counts sharply decreased to 21.1 (14.8-26.3) × 10(9) /L and then temporarily recovered to 25.9 (18.9-36.5) × 10(9) /L (P ≤ 0.001) over the next 8 h.
  
  
  CONCLUSIONS
  Single doses of lenograstim with or without DXM induced a PMN plateau that lasted 9 h (12-21 h after mobilization), with PMN counts suitable for neutrophil collection. Lenograstim plus DXM made it possible to perform NA twice, 12 and 36 h after mobilization.
authors.affiliation: Institute for Transfusion Medicine, Hannover Medical School, Germany.
authors.forename: Kian
authors.initials: K
authors.lastname: Kessler
authors.forename: Lilia
authors.initials: L
authors.lastname: Goudeva
authors.forename: Hans-Gert
authors.initials: HG
authors.lastname: Heuft
mesh_terms: D000328:Adult; D001782:Blood Donors; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006098:Granulocytes / Q000187:drug effects; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007700:Kinetics; D000078224:Lenograstim; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D009504:Neutrophils / Q000187:drug effects; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000078224:Lenograstim; D003907:Dexamethasone