CD34+ cell mobilization for allogeneic progenitor cell transplantation: Efficacy of a short course of rHuG-CSF

Paolo De Fabritiis, Anna Paola Iori, Andrea Mengarelli, Maria Gozzer, Giancarlo Ferrazza, Maria S. De Propris, Atelda Romano, William Arcese

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Abstract

Background: G-CSF-mobilized progenitor cells are increasingly being employed for allogeneic transplantation. However, the potential side effects for the donors still limits a wider use of the procedure. Different doses of G-CSF have been used to mobilize progenitor cells, collected by repeated leukaphereses at days 5-8 from G-CSF administration. Objective: We evaluated whether 3-day administration of G-CSF to normal donors would result in a mobilization of 4 × 10 6 CD34+ cells/kg of the recipient and whether engraftment and outcome after transplant would be comparable to those reported with stem cells mobilized for a longer period. Methods: Gly-rHuG-CSF (Lenograstin) was given at 10g/ kg/day in 2 doses over 3 days followed by a leukapheresis 12 hours later. CD34+ cells were monitored during the procedure in order to optimize the duration of leukapheresis. 30 consecutive patients with CML (n=7), AML (n=15), ALL (n=5), multiple myeloma (n=l)or myelofibrosis (n=2)were transplanted in different phase of the diseases. No growth factors were given during the recovery phase from transplant. Results: A median of 53.5 CD34+ cells/1 (19-190) was found in the 30 donors on the day of first leukapheresis, which allowed a median CD34+ cell collection of 6.5 × 10 6/kg (4.2-17.4) of the recipient. In 83% of donors a single procedure was sufficient to collect the target CD34+ cells, while in 17% two leukaphereses were required. The G-CSF schedule and the leukapheresis procedures were well tolerated. Haematological reconstitution was observed at a median of 14 days (10-23) for neutrophils and 14.5 days (11-46) for platelets. With a median infusion of 3.9 × 10 8 CD3+ lymphocytes/kg of the recipient (1.3-7.8), the acute and chronic GvHD occurred in 43% and 60% of the évaluable patients, respectively. At present, 73% of patients are in CR at a median of 337 days (160-615) and 80% are surviving at a median of 350 days (160-615) from transplantation. Conclusions: The 3-day schedule of rHuG-CSF to normal donors resulted in a valuable mobilization of progenitor cells that allowed a prompt and stable reconstitution in patients admitted to an allogeneic transplantation. Our schedule of rHuG-CSF administration followed by a single leukapheresis can be proposed and widely accepted since 83% of healthy donors reach the target in the estimated time with a limited growth factor exposition and a reduced global cost of the procedure.

Original languageEnglish
JournalBlood
Volume96
Issue number11 PART I
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Hematology

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    De Fabritiis, P., Iori, A. P., Mengarelli, A., Gozzer, M., Ferrazza, G., De Propris, M. S., Romano, A., & Arcese, W. (2000). CD34+ cell mobilization for allogeneic progenitor cell transplantation: Efficacy of a short course of rHuG-CSF. Blood, 96(11 PART I).