Bishop M R, Tarantolo S R, Jackson J D, Anderson J R, Schmit-Pokorny K, Zacharias D, Pavletic Z S, Pirruccello S J, Vose J M, Bierman P J, Warkentin P I, Armitage J O, Kessinger A
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330, USA.
J Clin Oncol. 1997 Apr;15(4):1601-7. doi: 10.1200/JCO.1997.15.4.1601.
The optimal dose of granulocyte colony-stimulating factor (G-CSF) for mobilization of allogeneic-blood stem cells (AlloBSC) has yet to be determined. As part of a prospective trial, 41 related human leukocyte antigen (HLA)-matched donors had blood cells mobilized with G-CSF at 5 micrograms/kg/d by subcutaneous administration. The purpose of this trial was to monitor adverse effects during G-CSF administration and stem-cell collection, to determine the optimal timing for stem-cell collection, and to determine the cellular composition of stem-cell products following G-CSF administration.
The median donor age was 42 years. Apheresis began on day 4 of G-CSF administration. At least three daily 12-L apheresis collections were performed on each donor. A minimum of 1.0 x 10(6) CD34+ cells/kg (recipient weight) and 8.0 x 10(8) mononuclear cells/kg were collected from each donor. All collections were cryopreserved in 5% dimethyl sulfoxide and 6% hydroxyethyl starch.
Toxicities associated with G-CSF administration and the apheresis process included myalgias/arthralgias (83%), headache (44%), fever (27%), and chills (22%). The median baseline platelet count of 242 x 10(4)/ mL decreased to 221, 155, and 119 x 10(6)/mL on days 4, 5, and 6 of G-CSF administration, respectively. Median numbers of CD34+ cells in collections 1, 2, and 3 were 1.99, 2.52, and 3.13 x 10(6)/kg, respectively. The percentage and total number of CD4+, CD8+, and CD56+/CD3- cells remained relatively constant during the three collections. Median total numbers of cells were as follows: CD34+, 7.73 x 10(6)/kg; and lymphocytes, 6.93 x 10(8)/kg.
Relatively low doses of G-CSF can mobilize sufficient numbers of AlloBSC safely and efficiently.
动员异基因造血干细胞（AlloBSC）的粒细胞集落刺激因子（G-CSF）最佳剂量尚未确定。作为一项前瞻性试验的一部分，41名人类白细胞抗原（HLA）配型相合的相关供者通过皮下注射5微克/千克/天的G-CSF来动员血细胞。该试验的目的是监测G-CSF给药和干细胞采集过程中的不良反应，确定干细胞采集的最佳时机，并确定G-CSF给药后干细胞产品的细胞组成。
供者年龄中位数为42岁。在G-CSF给药第4天开始进行单采。对每位供者至少进行三次每日12升的单采采集。从每位供者采集至少1.0×10⁶个CD34⁺细胞/千克（受者体重）和8.0×10⁸个单核细胞/千克。所有采集物均保存在含5%二甲基亚砜和6%羟乙基淀粉中进行冷冻保存。
与G-CSF给药及单采过程相关的毒性反应包括肌痛/关节痛（83%）、头痛（44%）、发热（27%）和寒战（22%）。G-CSF给药第4、5和6天，基线血小板计数中位数242×10⁴/毫升分别降至221、155和119×10⁶/毫升。采集物1、2和3中CD34⁺细胞中位数分别为1.99、2.52和3.13×10⁶/千克。在三次采集过程中，CD4⁺、CD8⁺和CD56⁺/CD3⁻细胞的百分比和总数保持相对稳定。细胞总数中位数如下：CD34⁺为7.73×10⁶/千克；淋巴细胞为6.93×10⁸/千克。
相对低剂量的G-CSF能够安全有效地动员足够数量的异基因造血干细胞。
