title: Mobilization and collection of CD34(+) cells for autologous transplantation of peripheral blood hematopoietic progenitor cells in children: analysis of two different granulocyte-colony stimulating factor doses.
abstract: BACKGROUND
  The use of peripheral hematopoietic progenitor cells (HPCs) is the cell choice in autologous transplantation. The classic dose of granulocyte-colony stimulating factor (G-CSF) for mobilization is a single daily dose of 10μg/kg of patient body weight. There is a theory that higher doses of granulocyte-colony stimulating factor applied twice daily could increase the number of CD34(+) cells collected in fewer leukapheresis procedures.
  
  
  OBJECTIVE
  The aim of this study was to compare a fractionated dose of 15μg G-CSF/kg of body weight and the conventional dose of granulocyte-colony stimulating factor in respect to the number of leukapheresis procedures required to achieve a minimum collection of 3×10(6) CD34(+) cells/kg body weight.
  
  
  METHODS
  Patients were divided into two groups: Group 10 - patients who received a single daily dose of 10μg G-CSF/kg body weight and Group 15 - patients who received a fractioned dose of 15μg G-CSF/kg body weight daily. The leukapheresis procedure was carried out in an automated cell separator. The autologous transplantation was carried out when a minimum number of 3×10(6) CD34(+) cells/kg body weight was achieved.
  
  
  RESULTS
  Group 10 comprised 39 patients and Group 15 comprised 26 patients. A total of 146 apheresis procedures were performed: 110 (75.3%) for Group 10 and 36 (24.7%) for Group 15. For Group 10, a median of three (range: 1-7) leukapheresis procedures and a mean of 8.89×10(6) CD34(+) cells/kg body weight (±9.59) were collected whereas for Group 15 the corresponding values were one (range: 1-3) and 5.29×10(6) cells/kg body weight (±4.95). A statistically significant difference was found in relation to the number of apheresis procedures (p-value <0.0001).
  
  
  CONCLUSIONS
  To collect a minimum target of 3×10(6) CD34(+) cells/kg body weight, the administration of a fractionated dose of 15μg G-CSF/kg body weight significantly decreased the number of leukapheresis procedures performed.
authors.affiliation: Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Centro Infantil Boldrini, Campinas, SP, Brazil. Electronic address: katia.eid@hotmail.com.
authors.forename: Kátia Aparecida de Brito
authors.initials: KA
authors.lastname: Eid
authors.affiliation: Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
authors.forename: Eliana Cristina Martins
authors.initials: EC
authors.lastname: Miranda
authors.affiliation: Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil; Centro Infantil Boldrini, Campinas, SP, Brazil.
authors.forename: Simone Dos Santos
authors.initials: Sdos S
authors.lastname: Aguiar
keywords: Autologous transplantation; Granulocyte colony-stimulating factor; Hematopoietic stem cell mobilization; Leukapheresis