¹Siteman Cancer Center and Department of Medicine, Division of Oncology, Section of Stem Cell Transplantation, Leukemia, and Stem Cell Biology, Washington University School of Medicine, St Louis, MO, USA

Correspondence: Dr SM Devine, 660 S. Euclid Avenue, Campus Box 8007, St Louis, MO 63110, USA. E-mail: sdevine@im.wustl.edu

²Both these authors contributed equally to this study.

Received 10 March 2005; Accepted 1 June 2005; Published online 18 July 2005.

Abstract

We retrospectively reviewed the results of transplanting peripheral blood progenitor cell (PBPC) allografts from HLA-matched sibling donors mobilized using various hematopoietic cytokines. Patients had received allografts mobilized with Granulocyte colony-stimulating factor (G-CSF) (G, N=65) alone, G plus Granulocyte-macrophage colony stimulating factor (GM-CSF) (G/GM, N=70), or GM-CSF alone at 10 or 15 g/kg/day (GM, N=10 at 10 g/kg/day and 21 at 15 g/kg/day). The CD34+ and CD3+ cell content of grafts were significantly lower following GM alone compared to G alone (P<0.001 and 0.04, respectively). Nonhematopoietic toxicity observed in donors precluded dose escalation of GM-CSF beyond 10 g/kg/day. Hematopoietic recovery was similar among all three groups. Grades II–IV acute graft-versus-host disease (GVHD) was observed in only 13% of patients in the GM alone group compared to 49 and 69% in the G alone or G/GM groups, respectively (P<0.001). In a multivariate analysis, receipt of PBPC mobilized with GM alone was associated with a lower risk of grades II–IV acute GVHD (hazard ratio 0.21; 95% CI 0.073, 0.58) compared to G alone or G/GM. There were no differences in relapse risk or overall survival among the groups. Donor PBPC grafts mobilized with GM-CSF alone result in prompt hematopoietic engraftment despite lower CD34+ cell doses and may reduce the risk of grades II–IV acute GVHD following HLA-matched PBPC transplantation.