Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Peripheral hematopoietic stem cell mobilization utilizing growth factors in donors with sickle cell trait is safe and effective

Bone Marrow Transplantation volume 53, pages 1366–1368 (2018)Cite this article

Subjects

Allogeneic hematopoietic stem cell transplantation (HCT) is a curative treatment for sickle cell disease (SCD). However, the majority of patients in need of such therapy are ineligible due to underlying comorbidities or lack of available donor . Recent literature attempting to expand the donor pool via utilizing matched unrelated donors or cord blood units was hampered by significant toxicity due to graft vs. host disease (GVHD) or graft failure [1, 2]. Furthermore, although peripheral stem cell mobilization using granulocyte colony stimulating factor (GCSF) is widely used in allogeneic HCT, patients with SCD are prone to significant risks with GCSF including splenic rupture or death, in part due to precipitation of vaso-occlusive crises (VOC) [3, 4]. Although sickle cell trait (SCT) is a relatively benign disorder related to SSD, there are reports of VOC in such patients during conditions of severe stress [5]. There is paucity in the literature with regards to the safety of GCSF in SCT carriers; therefore our aim from this analysis was to examine the safety and efficacy of utilizing growth factors in donors with SCT.

After due IRB approval, allogeneic donors for sibling recipients with SCD were identified and medical records retrospectively extracted. A sickle cell screen was performed and if positive, high-performance liquid chromatography (HPLC) was done. All donors were interviewed for symptoms post mobilization and a survey was completed to inquire about related adverse effects, graded by the common terminology criteria for adverse events (CTCAE) v.4.0. GCSF was administered at a dose of 10 mcg/kg rounded to the nearest vial size for 5 days followed by high flow apheresis on the fifth day. CD34 enumeration was measured on days 4 and 5. At our center, the ideal collection target was ≥10 × 106/kg CD34 cells of recipient weight to allow safe engraftment in the context of SCD. Stem cells were infused on the same day of collection without cryopreservation. Categorical and continuous variables were compared using Pearson’s chi-squared and Wilcoxon/Kruskal–Wallis, respectively. Analysis was computed using JMP Pro Version 11 (SAS Institute, Cary, NC, USA) software.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Shenoy S, Eapen M, Panepinto JA, Logan BR, Wu J, Abraham A, et al. A trial of unrelated donor marrow transplantation for children with severe sickle cell disease. Blood. 2016;128:2561–7.

    Article  CAS  Google Scholar 

  2. Kamani NR, Walters MC, Carter S, Aquino V, Brochstein JA, Chaudhury S, et al. Unrelated donor cord blood transplantation for children with severe sickle cell disease: results of one cohort from the phase II study from the Blood and Marrow Transplant Clinical Trials Network (BMT CTN). Biol Blood Marrow Transplant. 2012;18:1265–72.

    Article  Google Scholar 

  3. Adler BK, Salzman DE, Carabasi MH, Vaughan WP, Reddy VV, Prchal JT. Fatal sickle cell crisis after granulocyte colony-stimulating factor administration. Blood. 2001;97:3313–4.

    Article  CAS  Google Scholar 

  4. Fitzhugh CD, Hsieh MM, Bolan CD, Saenz C, Tisdale JF. Granulocyte colony-stimulating factor (G-CSF) administration in individuals with sickle cell disease: time for a moratorium? Cytotherapy. 2009;11:464–71.

    Article  CAS  Google Scholar 

  5. Dudley AW Jr, Waddell CC. Crisis in sickle cell trait. Hum Pathol. 1991;22:616–8.

    Article  Google Scholar 

  6. Gereklioglu C, Asma S, Korur A, Tepebasi S, Aytan P, Yeral M, et al. Granulocyte-colony stimulating factor administration among hemoglobin S trait donors: a single center experience from the Eastern Mediterranean region. J Clin Apher. 2018;33:65–71.

    Article  Google Scholar 

  7. Al-Khabori M, Al-Ghafri F, Al-Kindi S, Al-Riyami AZ, Al-Farsi K, Al-Huneini M, et al. Safety of stem cell mobilization in donors with sickle cell trait. Bone Marrow Transplant. 2015;50:310–1.

    Article  CAS  Google Scholar 

  8. Kang EM, Areman EM, David-Ocampo V, Fitzhugh C, Link ME, Read EJ, et al. Mobilization, collection, and processing of peripheral blood stem cells in individuals with sickle cell trait. Blood. 2002;99:850–5.

    Article  CAS  Google Scholar 

  9. Favre G, Beksac M, Bacigalupo A, Ruutu T, Nagler A, Gluckman E, et al. Differences between graft product and donor side effects following bone marrow or stem cell donation. Bone Marrow Transplant. 2003;32:873–80.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia

    Moussab Damlaj, Ahmed Alaskar, Samer Ghazi, Bader Alahmari, Ayman Alhejazi & Mohsen Al-Zahrani

  2. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

    Moussab Damlaj, Ahmed Alaskar, Ayman Alhejazi & Mohsen Al-Zahrani

  3. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    Moussab Damlaj, Ahmed Alaskar, Ayman Alhejazi & Mohsen Al-Zahrani

Authors
  1. Moussab Damlaj
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmed Alaskar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Samer Ghazi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bader Alahmari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ayman Alhejazi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mohsen Al-Zahrani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Moussab Damlaj.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Damlaj, M., Alaskar, A., Ghazi, S. et al. Peripheral hematopoietic stem cell mobilization utilizing growth factors in donors with sickle cell trait is safe and effective. Bone Marrow Transplant 53, 1366–1368 (2018). https://doi.org/10.1038/s41409-018-0208-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41409-018-0208-3

Search

Advanced search

Quick links