Kröger N, Renges H, Sonnenberg S, Krüger W, Gutensohn K, Dielschneider T, Cortes-Dericks L, Zander A R
Department of Bone Marrow Transplantation, University of Hamburg, Germany.
Bone Marrow Transplant. 2002 May;29(9):727-30. doi: 10.1038/sj.bmt.1703509.
We compared two doses of recombinant human granulocyte-stimulating factor (G-CSF) for stem cell mobilisation in 90 healthy donors for allogeneic stem cell transplantation in a retrospective analysis. Group I (n = 46) received 10 microg/kg G-CSF (filgrastim) given as 5 microg/kg twice daily, and group II (n = 44) received 16 microg/kg, given as 8 microg/kg twice daily with a 12-h interval. The groups were well-balanced for age and body-weight. G-CSF application was performed on an out-patient basis, and leukapheresis was started in all donors on day 5. The most frequent side-effects of G-CSF were grade I/II, bone pain, headache and fatigue in both groups, whereas grade III of bone pain, headache and fatigue occurred in the 2 x 8 microg/kg group only. One serious non-fatal event with non-traumatic spleen rupture occurred in the 2 x 5 microg/kg group. The CD34(+)cell count in the first apheresis of all donors was 5.1 x 10(6)/kg donor weight (range, 1.5-19.3). The CD34(+) cell harvest was higher in the 2 x 8 microg/kg group than in the 2 x 5 microg/kg group (7.1 x 10(6)/kg vs 4.9 x 10(6)/kg; P = 0.09). The target of collecting >5.0 x 10(6) CD34(+) cells/kg donor weight with one apheresis procedure was achieved in 45% of group I and in 61% of group II, respectively. Administering G-CSF at a dosage of 8 microg/kg twice daily leads to a higher CD34(+) cell yield than a dosage of 2 x 5 microg/kg, but is associated with increased toxicity and higher cost.
我们在一项回顾性分析中,比较了两种剂量的重组人粒细胞集落刺激因子(G-CSF)对90名进行异基因干细胞移植的健康供者进行干细胞动员的效果。第一组(n = 46)接受10微克/千克G-CSF(非格司亭),每日两次,每次5微克/千克;第二组(n = 44)接受16微克/千克,每日两次,每次8微克/千克,间隔12小时。两组在年龄和体重方面均衡良好。G-CSF在门诊应用,所有供者在第5天开始进行白细胞分离术。两组中G-CSF最常见的副作用为I/II级骨痛、头痛和疲劳,而骨痛、头痛和疲劳的III级仅出现在2×8微克/千克组。2×5微克/千克组发生了1例非创伤性脾破裂的严重非致命事件。所有供者首次采集时的CD34(+)细胞计数为5.1×10⁶/千克供者体重(范围为1.5 - 19.3)。2×8微克/千克组的CD34(+)细胞收获量高于2×5微克/千克组(7.1×10⁶/千克对4.9×10⁶/千克;P = 0.09)。一次采集程序收集到>5.0×10⁶ CD34(+)细胞/千克供者体重的目标分别在第一组的45%和第二组的61%中实现。每日两次给予8微克/千克剂量的G-CSF比2×5微克/千克剂量产生更高的CD34(+)细胞产量,但与毒性增加和成本更高相关。