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Mobilization and collection of PBSC in healthy donors: comparison between two schemes of rhG‐CSF administration

Abstract:  Procurement of a high number of progenitor cells is of primary interest in allogeneic PBSC transplantation. We have retrospectively compared toxicity, mobilization effect and progenitor cell yields of two different rhG‐CSF schedules in 11 consecutive healthy individuals donating their PBSC. Five of them received rhG‐CSF 16 μg/kg/d for 4 subsequent d in 2 divided subcutaneous injections (group A); similarly, 6 donors received rhG‐CSF 10 μg/kg/d for 5 d (group B). The aphereses were started the last day of rhG‐CSF treatment; 9 donors underwent 2 aphereses, one underwent 1 and another 3 procedures, always on subsequent days. Toxicity was mild, but moderate thrombocytopenia developed following apheretic collections, irrespective of rhG‐CSF schedule. In all the donors WBC, as well as circulating CD34+ cells, CFU‐GM, CFU‐GEMM and BFU‐E dramatically increased over the baseline values, peaking on d 5 or 6, with no statistical difference between the 2 groups for the height of the cell peaks. Also the peripheral lymphoid cell populations (CD3+, CD19+ and CD56+/CD3‐) increased following the rhG‐CSF administration. The number of MNC, CFU‐GM, BFU‐E, CFU‐GEMM, as well as CD34+, CD3+, CD19+ and CD56+/CD3 cells collected by apheresis showed no statistical difference in the 2 groups. Overall, 8 of the 11 donors collected the target number of CD34+ cells > 4times106/kg ideal recipient body weight with the first apheresis, with no difference between the 2 groups. Mobilization with rhG‐CSF in healthy donors enables the collection of large number of progenitor cells with modest side effects. A schedule of 10 μg/kg for 5 d is as effective as 16 μg/kg for 4 d. A single apheresis would be enough in 80% of cases.