Progenitor Cell Mobilisation

Peripheral blood stem cell mobilization and apheresis: analysis of adverse events in 94 normal donors

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Abstract

Adverse events were analyzed in 94 normal donors who underwent PBSC harvest with G-CSF. The median dose of G-CSF was 9.7 μg/kg/day (range, 2.0–16.7), and the duration of administration was 4–6 days. Frequent symptoms were bone pain (71%), general fatigue (33%), headache (28%), insomnia (14%), anorexia (11%), nausea and/or vomiting (11%). One donor (1%) developed grade 3 toxicity bone pain (WHO criteria). WBC counts and ANC increased during G-CSF administration. After leukapheresis, three donors (3%) developed grade 3 toxicity neutropenia. Platelet counts decreased after leukapheresis. Three donors (3%) developed grade 3 thrombocytopenia. The means of both ALP and LDH increased approximately 1.9-fold compared with pretreatment levels. In one pediatric donor (1%), ALP was elevated to the grade 3 toxicity level. From multivariate analysis, the incidence of bone pain increased when G-CSF was given at a dose of 8.8 μg/kg/day or more, headaches were frequent in donors younger than 35 years, and the incidence of nausea and/or vomiting was high in female donors. The peak levels of WBC counts and ANC and post-treatment level of LDH increased in correspondence with the escalation of G-CSF dose. All adverse events normalized on follow-up evaluation. In conclusion, although PBSC harvest for normal donors is acceptable, care must be taken for all donors in terms of their sex and age as well as the G-CSF dose. We recommend less than 8.8 μg/kg/day as the G-CSF dose for PBSC mobilization in normal donors.

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Correspondence to M Murata.

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Murata, M., Harada, M., Kato, S. et al. Peripheral blood stem cell mobilization and apheresis: analysis of adverse events in 94 normal donors. Bone Marrow Transplant 24, 1065–1071 (1999) doi:10.1038/sj.bmt.1702038

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Keywords

  • granulocyte colony-stimulating factor
  • peripheral blood stem cells
  • mobilization
  • apheresis
  • allogeneic transplantation
  • donor

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