Liang Ze-Yin, Ren Han-Yun
Department of Hematology, Peking University First Hospital, Beijing 100034, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Aug;16(4):847-51.
This study was aimed to explore the factors impacting on effect of the recombinant human granulocyte colony-stimulating factor (rhG-CSF) in mobilizing and collecting peripheral blood stem/progenitor cells (PBSPC) from healthy donors, and to determine the optimal time for PBSPC harvest. A mobilization course in 431 healthy donors was retrospectively studied and the factors influencing the efficacy of mobilization were analyzed. The normal donors underwent leukapheresis for PBSPC collection in multicentres after mobilization with G-CSF administered. A variety of items analyzed included donor age, sex, weight, body mass index (BMI), daily G-CSF dose and schedule of G-CSF administration. The results showed that G-CSF was administered subcutaneously at median 5.7 microg/kg for mobilization for 3 - 5 days, The median number of peripheral blood mononuclear cells (PBMNC) count of per kg recipient weight was 9.57 x 10(8) and CD34(+) cells per kg recipient weight was 4.91 x 10(6) after a median of 1.7 leukapheresis. The side effects were mild and well tolerated. By univariate analysis, BMI, daily G-CSF dose and schedule of administration were significantly correlated with the yield of PBMNCs, CD34(+) cells. The best apheresis yields of PBMNCs and CD34(+) cells were achieved on day 5 after treatment with rhG-CSF. Because the narrow range and low dose of rhG-CSF administration, there were minor effects of rhG-CSF dose compared with schedule of administration. It is concluded that mobilization and leukapheresis are safe in healthy donors and that the low dose of rhG-CSF in 5-day administration are probably optimal for donor management.
本研究旨在探讨影响重组人粒细胞集落刺激因子(rhG-CSF)动员和采集健康供者外周血干/祖细胞(PBSPC)效果的因素,并确定采集PBSPC的最佳时间。回顾性研究了431例健康供者的动员过程,分析了影响动员效果的因素。正常供者在给予G-CSF动员后,在多中心进行白细胞单采以采集PBSPC。分析的项目包括供者年龄、性别、体重、体重指数(BMI)、每日G-CSF剂量和G-CSF给药方案。结果显示,皮下注射G-CSF进行动员的中位剂量为5.7μg/kg,持续3 - 5天,经过中位1.7次白细胞单采后,每千克受者体重外周血单个核细胞(PBMNC)计数的中位数为9.57×10⁸,每千克受者体重CD34⁺细胞数为4.91×10⁶。副作用轻微,耐受性良好。单因素分析显示,BMI、每日G-CSF剂量和给药方案与PBMNC、CD34⁺细胞的产量显著相关。rhG-CSF治疗后第5天获得PBMNC和CD34⁺细胞的最佳单采产量。由于rhG-CSF给药剂量范围窄且剂量低,与给药方案相比,rhG-CSF剂量的影响较小。结论是,动员和白细胞单采在健康供者中是安全的,5天低剂量rhG-CSF给药可能是供者管理的最佳方案。