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Colunga-Pedraza PR, Irabien-Zuñiga M, Rodriguez-Roque CS, de la Cruz-de la Cruz C, Gómez-De León A, Santana-Hernández P, Jaime-Pérez JC, Mancías-Guerra C, Gómez-Almaguer D. Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation. Hematol Transfus Cell Ther 2023; 45:435-441. [PMID: 36163321 PMCID: PMC10627851 DOI: 10.1016/j.htct.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/17/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Pre-apheresis peripheral blood CD34+ cell count (PBCD34+) is the most important predictor of good cell mobilization before hematopoietic stem cell transplantation, albeit flow cytometry is not always immediately available. Identification of surrogate markers can be useful. The CD34+ cells proliferate after mobilization, resulting in elevated lactate dehydrogenase (LDH) activity and correlating with the PBCD34+ count. OBJECTIVE To determine the LDH cut-off value at which adequate CD34+ cell mobilization is achieved and its diagnostic yield. MATERIALS AND METHODS A total of 103 patients who received an autologous stem cell transplantation (ASCT) between January 2015 and January 2020 were included. Demographic and laboratory characteristics were obtained, including complete blood count, pre-apheresis PBCD34+ and LDH levels. Receiver operating characteristic (ROC) curves were performed to identify the optimal serum LDH activity cut-off points for ≥ 2 and ≥ 4 × 106 cells/kg post-mobilization CD34+ count and their diagnostic yield. RESULTS A post-mobilization serum LDH cut-off value of 462 U/L yielded a sensitivity (Se) = 86.8% (positive predictive value [PPV] = 72.7%), a pre- and post-mobilization serum LDH difference cut-off value of 387 U/L, an Se = 45.7% (PPV = 97%) and an LDH ratio of 2.46, with an Se = 47.1% (PPV = 97%) for an optimal mobilization count (CD34+ ≥ 4 × 106). CONCLUSION The LDH measurement represents a fast and affordable way to predict PBCD34+ mobilization in cases where flow cytometry is not immediately available. According to the LDH diagnostic yield, it could be used as a surrogate marker in transplant centers, supporting the CD34+ count, which remains the gold standard.
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Affiliation(s)
- Perla R Colunga-Pedraza
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - Mariela Irabien-Zuñiga
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - Carlos Saúl Rodriguez-Roque
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - Carlos de la Cruz-de la Cruz
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - Andrés Gómez-De León
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - Paola Santana-Hernández
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - José Carlos Jaime-Pérez
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - Consuelo Mancías-Guerra
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México
| | - David Gómez-Almaguer
- Hematology Service, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Francisco I. Madero Ave. No number. Mitras Centro, Monterrey, Nuevo León, México.
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Chang HH, Liou YS, Sun DS. Hematopoietic stem cell mobilization. Tzu Chi Med J 2022; 34:270-275. [PMID: 35912054 PMCID: PMC9333105 DOI: 10.4103/tcmj.tcmj_98_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/28/2021] [Accepted: 06/25/2021] [Indexed: 12/27/2022] Open
Abstract
Hematopoietic stem cell (HSC) transplantation has been used to treat hematopoietic diseases for over 50 years. HSCs can be isolated from bone marrow (BM), umbilical cord blood, or peripheral blood. Because of lower costs, shorter hospitalization, and faster engraftment, peripheral blood has become the predominant source of HSCs for transplantation. The major factors determining the rate of successful HSC transplantation include the degree of human leukocyte antigen matching between the donor and recipient and the number of HSCs for transplantation. Administration of granulocyte colony-stimulating factor (G-CSF) alone or combined with plerixafor (AMD3100) are clinical used methods to promote HSC mobilization from BM to the peripheral blood for HSC transplantations. However, a significant portion of healthy donors or patients may be poor mobilizers of G-CSF, resulting in an insufficient number of HSCs for the transplantation and necessitating alternative strategies to increase the apheresis yield. The detailed mechanisms underlying G-CSF-mediated HSC mobilization remain to be elucidated. This review summarizes the current research on deciphering the mechanism of HSC mobilization.
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Affiliation(s)
- Hsin-Hou Chang
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan
| | - Yu-Shan Liou
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan
| | - Der-Shan Sun
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan
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Long-acting granulocyte colony-stimulating factor pegfilgrastim (lipegfilgrastim) for stem cell mobilization in multiple myeloma patients undergoing autologous stem cell transplantation. Int J Hematol 2021; 114:363-372. [PMID: 34213732 DOI: 10.1007/s12185-021-03177-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 12/22/2022]
Abstract
Autologous stem cell transplantation (ASCT) is a standard of care in newly-diagnosed multiple myeloma (MM) patients. Several studies before the introduction of novel therapies in MM, demonstrated a pegylated G-CSF to be successful in mobilizing peripheral blood stem cells (PBSCs). Lipegfilgrastim is a novel long-acting G-CSF that is produced by the conjugation of a single 20-kDa polyethelene glycol to the natural O-glycosylation site of G-CSF. Twenty-four MM patients were included for PBSCs mobilization with a single SC injection of 6 mg lipegfilgrastim. PBSC collection was started when the CD34+ count was > 10 × 106 cells/L. The target progenitor cells were 6 × 106 cells/kg. The median day of apheresis was + 3 (range 2-5) following lipegfilgrastim. Median peripheral blood CD34+ count pre-mobilization was of 22.65 (range 3.36-105) × 106 cells/L. The median number of leukaphaeresis procedures was 2 (range 1-4). The median mobilized CD34+ cells/kg were 8.26 (range 0.77-12.42). One patient failed to mobilize and two patients mobilized < 6 × 106 cells/kg. Toxicity was mild and transient. Twenty-three patients underwent ASCT following high dose melphalan. All patients engrafted. As lipegfilgrastim is administered only once, it is conceivable that it improves both compliance and quality-of-life (NCT02488382).
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YİĞENOĞLU TN, BAŞCI S, ŞAHİN D, BAKIRTAŞ M, KILINC A, UNCU ULU B, BATGİ H, İSKENDER D, OZCAN N, KIZIL ÇAKIR M, DAL S, HACIBEKİROĞLU T, ALTUNTAŞ F. The effect of smoking on stem cell mobilization in allogeneic donors. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.729505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Kimura S, Ohkawara H, Minakawa K, Fukatsu M, Mori H, Takahashi H, Harada-Shirado K, Ohara Y, Takahashi N, Mochizuki K, Sano H, Nollet KE, Ogawa K, Ohto H, Kikuta A, Ikeda K, Ikezoe T. Optimal timing of apheresis for the efficient mobilization of peripheral blood progenitor cells recruited by high-dose granulocyte colony-stimulating factor in healthy donors. Transfus Apher Sci 2020; 59:102737. [DOI: 10.1016/j.transci.2020.102737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
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Yiğenoğlu TN, Başcı S, Bakırtaş M, Ulu BU, Kılınç A, Şahin D, Darçın T, Yıldız J, Merdin A, Baysal NA, İskender D, Çakar MK, Dal MS, Hacıbekiroğlu T, Altuntaş F. The effect of serum vitamin B12, folate, ferritin levels and transferrin saturation on stem cell mobilization in allogeneic donors. Transfus Apher Sci 2020; 59:102726. [PMID: 32008954 DOI: 10.1016/j.transci.2020.102726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 11/27/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Peripheric blood derived stem cells are used in 75 % of allogeneic stem cell transplantations. Iron, vitamin B12 and folate involve in hematopoiesis. Therefore serum levels of iron, vitamin B12 and folat may effect stem cell mobilization. We aimed to analyze the effects of iron status, vitamin B12 and folate levels on peripheric blood stem cell mobilization in healthy donors. METHOD The mobilization results of 218 allogeneic donors were analyzed retrospectively. RESULTS In 64 donors, serum ferritin level was <15 μg / L and transferrin saturation was <20 %. When we compared the donors with iron deficiency to the donors without iron deficiency, the number of collected CD34 + cell was significantly higher in donors without iron deficiency. We did not find any impact of serum vitamin B12 and folate level on CD34+ cells collected. CONCLUSION Our study shows that serum ferritin and transferrin saturation have a greater effect on the amount of CD34+ cells collected from donors than serum vitamin B12 and folate levels. Consequently, when compliance tests of allogeneic donors are performed, the evaluation of vitamin B12 and folate levels is not necessary; whereas iron deficiency must be assessed and -if possible- corrected before apheresis is performed.
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Affiliation(s)
- Tuğçe Nur Yiğenoğlu
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Semih Başcı
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Mehmet Bakırtaş
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Bahar Uncu Ulu
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ali Kılınç
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Derya Şahin
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Tahir Darçın
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Jale Yıldız
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Alparslan Merdin
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nuran Ahu Baysal
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Dicle İskender
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Merih Kızıl Çakar
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Sinan Dal
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Tuba Hacıbekiroğlu
- Department of Hematology, Sakarya University Hospital, Medical Faculty, Sakarya, Turkey
| | - Fevzi Altuntaş
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Zhen C, Fang X, Ding M, Wang X, Yuan D, Sui X, Liu X, Zhang L, Xu H, Li Y, Wang X. Smoking is an important factor that affects peripheral blood progenitor cells yield in healthy male donors. J Clin Apher 2019; 35:33-40. [PMID: 31693224 DOI: 10.1002/jca.21756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/19/2019] [Accepted: 09/26/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Smoking could reduce the CD34+ cells in peripheral blood of healthy individual. This study aimed to investigate the correlation between smoking load and the effect of peripheral blood hematopoietic progenitor cells (PBPCs) mobilization by granulocyte colony-stimulating factor (G-CSF) alone in healthy donors. METHODS Retrospective analysis was performed on 145 healthy adult PBPCs donors who underwent PBPCs mobilization and collection. Smoking factors were evaluated and correlated with mobilization responses, as indicated by the collected CD34+ cells concentration. RESULTS The collected CD34+ cells concentration was closely related to pre-CD34 (P < .001) and CD34+ cells collected per volume blood processed (P < .001) which suggested that collected CD34+ cells concentration was a reliable indicator of PBPCs mobilization efficiency. The heavy smoking donors revealed significantly lower collected CD34+ cells concentration, compared to that of the nonsmoking (P < .001) and light smoking donors (P < .05). The levels of collected CD34+ cells in light smoking were also obviously lower than that in nonsmoking donors (P < .05).There were no obvious differences in the collected CD34+ cells concentration, overall processed blood volume and total collected CD34+ cells between nonsmoking and smoking cessation groups (P = .490; P = .464; P = .819). CONCLUSION Cigarette smoking is an important factor that affects the yield of PBPCs in male donors, especially when the smoking load is more than five pack-years. Mobilization of PBMCs could be restored by smoking cessation in chronic smokers.
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Affiliation(s)
- Changqing Zhen
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Mei Ding
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Xianghua Wang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Dai Yuan
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Xiaohui Sui
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Xin Liu
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Lingyan Zhang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Hongzhi Xu
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Ying Li
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Department of Diagnostics, Shandong University School of Medicine, Jinan, Shandong, China
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Murugesan M, Shringarpure K, Karthickeyan DSA, Nair CK, Nayanar SK, Venugopal V, Selvaraj K, Rathi P, Mehta KG, Deenathayalan V, Gayathiri KC. Clinical and equipment-related factors associated with the adequate peripheral blood stem cell collection in autologous transplant at a tertiary cancer center in Kerala - A retrospective cohort study. Transfus Apher Sci 2019; 58:457-463. [PMID: 31255504 DOI: 10.1016/j.transci.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/01/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND PBSC collection using apheresis is the preferred source of hematopoietic stem cells transplantation. However, apheresis procedures fail to harvest adequate CD34 yield in 5 to 40% of patients during the first collection. Therefore, this study aimed to study both the clinical- and equipmentrelated factors influencing CD34 yield among the autologous patients and to compare the collection efficiency of two apheresis equipments(Haemonetics MCS+ and Terumo Spectra Optia). METHODS Retrospective analysis of 69 patients underwent PBSC collection from 2015 to 2018. Frequency, clinical- and equipment-related factors responsible for adequate CD34+ cells (≥2 x106 cells/kg) yield during the first collection was studied. Factors such as collection efficiency, percentage platelet loss and percentage hemoglobin loss were considered to compare the two apheresis system. RESULTS Two-third (72%) patients of the study population had adequate CD34 stem cells yield during the first collection. Factors such as exposure to lenalidomide-based pretreatment regimen, peripheral blood WBC count and CD34 count are associated with the adequate CD34 yield. Optia had a slightly better collection efficiency than MCS+ (50 and 44; p=0.37). Optia had lower product volume (237 vs 298 ml) and lesser procedure duration (277 vs 360 min), whereas the median Hb loss (3.0% and 2.3%) and mean platelet loss (49% and 34%) were higher with MCS. CONCLUSION This study infers that the collection efficiency of both the equipments in collecting CD34 stem cells was similar. However, during PBSC collection, procedures using Optia can be preferred to MCS+ on the patients with risk of anemia and thrombocytopenia.
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Affiliation(s)
- M Murugesan
- Dept. of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India.
| | | | | | - C K Nair
- Dept. of Clinical Hematology, Malabar Cancer Centre, Thalassery, Kerala, India
| | - S K Nayanar
- Dept. of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India
| | - V Venugopal
- Dept. of Community Medicine, Sri Manakula Vinayagar Medical College, Puducherry, India
| | - K Selvaraj
- Dept. of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - P Rathi
- Dept. of Community Medicine, Kasturba Medical College, Mangalore, India
| | - K G Mehta
- Community Medicine Department, GMERS Medical college Gotri, Vadodara, India
| | | | - K C Gayathiri
- Dept. of Transfusion Medicine, Malabar Cancer Centre, Thalassery, Kerala, India
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Thunström Salzer A, Niemiec MJ, Hosseinzadeh A, Stylianou M, Åström F, Röhm M, Ahlm C, Wahlin A, Ermert D, Urban CF. Assessment of Neutrophil Chemotaxis Upon G-CSF Treatment of Healthy Stem Cell Donors and in Allogeneic Transplant Recipients. Front Immunol 2018; 9:1968. [PMID: 30254629 PMCID: PMC6141688 DOI: 10.3389/fimmu.2018.01968] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/10/2018] [Indexed: 12/15/2022] Open
Abstract
Neutrophils are crucial for the human innate immunity and constitute the majority of leukocytes in circulation. Thus, blood neutrophil counts serve as a measure for the immune system's functionality. Hematological patients often have low neutrophil counts due to disease or chemotherapy. To increase neutrophil counts and thereby preventing infections in high-risk patients, recombinant G-CSF is widely used as adjunct therapy to stimulate the maturation of neutrophils. In addition, G-CSF is utilized to recruit stem cells (SCs) into the peripheral blood of SC donors. Still, the actual functionality of neutrophils resulting from G-CSF treatment remains insufficiently understood. We tested the ex vivo functionality of neutrophils isolated from blood of G-CSF-treated healthy SC donors. We quantified chemotaxis, oxidative burst, and phagocytosis before and after treatment and detected significantly reduced chemotactic activity upon G-CSF treatment. Similarly, in vitro treatment of previously untreated neutrophils with G-CSF led to reduced chemotactic activity. In addition, we revealed that this effect persists in the allogeneic SC recipients up to 4 weeks after neutrophil engraftment. Our data indicates that neutrophil quantity, as a sole measure of immunocompetence in high-risk patients should be considered cautiously as neutrophil functionality might be affected by the primary treatment.
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Affiliation(s)
- Anna Thunström Salzer
- Department of Radiation Sciences, University of Umeå, Umeå, Sweden.,Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Maria J Niemiec
- Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Ava Hosseinzadeh
- Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Marios Stylianou
- Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Fredrik Åström
- Department of Radiation Sciences, University of Umeå, Umeå, Sweden
| | - Marc Röhm
- Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Clas Ahlm
- Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Anders Wahlin
- Department of Radiation Sciences, University of Umeå, Umeå, Sweden
| | - David Ermert
- Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
| | - Constantin F Urban
- Department of Clinical Microbiology & Laboratory of Molecular Infection Medicine Sweden, Umeå University, Umeå, Sweden
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Sakashita AM, Kondo AT, Yokoyama APH, Lira SMC, Bub CB, Souza AM, Cipolletta ANF, Alvarez KC, Hamerschlak N, Kutner JM, Chiattone CS. The impact of preapheresis white blood cell count on autologous peripheral blood stem cell collection efficiency and HSC infusion side effect rate. J Clin Apher 2018; 33:331-341. [DOI: 10.1002/jca.21614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/08/2017] [Accepted: 01/02/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Araci. M. Sakashita
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Andrea T. Kondo
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Ana Paula H. Yokoyama
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Sanny M. C. Lira
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Carolina B. Bub
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Aline M. Souza
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Andrea N. F. Cipolletta
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Kelen C. Alvarez
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Nelson Hamerschlak
- Hematology and Bone Marrow Transplant Unit; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Jose M. Kutner
- Hemotherapy and Cellular Therapy Department; Hospital Israelita Albert Einstein; Sao Paulo SP Brazil
| | - Carlos S. Chiattone
- Hematology Department - Faculdade de Ciências Médicas da Santa Casa de São Paulo, Sao Paulo, SP, Brazil
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Fettah A, Özbek N, Özgüner M, Azık F, Işık P, Avcı Z, Yaralı N, Uçkan D, Tunç B. Factors associated with bone marrow stem cell yield for pediatric allogeneic stem cell transplantation: The impact of donor characteristics. Pediatr Transplant 2017; 21. [PMID: 27813281 DOI: 10.1111/petr.12841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2016] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the effects of donor characteristics on CD34+ cell yield in BM harvest. Between April 2010 and November 2013, consecutive donors who underwent BM harvesting in our BM transplantation unit were retrospectively investigated. Donors were classified into two groups: those who donated BM without mobilization (steady-state BM donors) and those who received G-CSF for stem cell mobilization (G-CSF-primed BM donors). Donor characteristics (age, gender, race, body weight, BMI, and laboratory factors including donor's leukocyte, platelet, and monocyte) and their relationship with total nuclear cell and CD34+ cell numbers has been evaluated. A total of 64 healthy related donors (29 males/35 females, median age 11.2 years; 49 [76.6%] younger than 18 and 36 [56.3%] younger than 12 years) were included in the study. The median CD34+ cell yield in the harvest was 0.12×106 /L (0.02-0.21) in SS-BM donors and 0.18×106 /L (0.09-0.67) in GP-BM donors (P=.03). Median of CD34+ cell count given to recipients was 2.6×106 /recipient body weight (1.3-19.3) in SS-BM yields and 3.8×106 /recipient body weight (1.1-10.2) in GP-BM yields, respectively. Multiple regression analysis showed that donor height and pre-G-CSF platelet were the most important parameters to obtain a sufficient BM harvest. Our data suggest that the shorter donors and the donors with higher thrombocyte counts may offer more hematopoietic stem cell. The height and thrombocyte count of the donors should be taken into consideration before planning the targeted CD34+ cell count especially for pediatric donors.
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Affiliation(s)
- Ali Fettah
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Namık Özbek
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Meltem Özgüner
- Stem Cell Research Laboratory, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Fatih Azık
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Pamir Işık
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Zekai Avcı
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Neşe Yaralı
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Duygu Uçkan
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey.,Stem Cell Research Laboratory, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
| | - Bahattin Tunç
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara Children Hematology Oncology Research Hospital, Ankara, Turkey
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Pessach I, Resnick I, Shimoni A, Nagler A. G-CSF-primed BM for allogeneic SCT: revisited. Bone Marrow Transplant 2015; 50:892-8. [DOI: 10.1038/bmt.2015.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/04/2015] [Accepted: 01/05/2015] [Indexed: 01/08/2023]
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Hsu JW, Wingard JR, Logan BR, Chitphakdithai P, Akpek G, Anderlini P, Artz AS, Bredeson C, Goldstein S, Hale G, Hematti P, Joshi S, Kamble RT, Lazarus HM, O'Donnell PV, Pulsipher MA, Savani BN, Schears RM, Shaw BE, Confer DL. Race and ethnicity influences collection of granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells from unrelated donors, a Center for International Blood and Marrow Transplant Research analysis. Biol Blood Marrow Transplant 2015; 21:165-71. [PMID: 25316111 PMCID: PMC4272878 DOI: 10.1016/j.bbmt.2014.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/07/2014] [Indexed: 11/27/2022]
Abstract
Little information exists on the effect of race and ethnicity on collection of peripheral blood stem cells (PBSC) for allogeneic transplantation. We studied 10,776 donors from the National Marrow Donor Program who underwent PBSC collection from 2006 to 2012. Self-reported donor race/ethnic information included Caucasian, Hispanic, Black/African American (AA), Asian/Pacific Islander (API), and Native American (NA). All donors were mobilized with subcutaneous filgrastim at an approximate dose of 10 μg/kg/day for 5 days. Overall, AA donors had the highest median yields of mononuclear cells per liter and CD34(+) cells per liter of blood processed (3.1 × 10(9) and 44 × 10(6), respectively), whereas Caucasians had the lowest median yields at 2.8 × 10(9) and 33.7 × 10(6), respectively. Multivariate analysis of CD34(+) per liter mobilization yields using Caucasians as the comparator and controlling for age, gender, body mass index, and year of apheresis revealed increased yields in overweight and obese AA and API donors. In Hispanic donors, only male obese donors had higher CD34(+) per liter mobilization yields compared with Caucasian donors. No differences in CD34(+) per liter yields were seen between Caucasian and NA donors. Characterization of these differences may allow optimization of mobilization regimens to allow enhancement of mobilization yields without compromising donor safety.
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Affiliation(s)
- Jack W Hsu
- University of Florida Shands Cancer Center, Gainesville, Florida.
| | - John R Wingard
- University of Florida Shands Cancer Center, Gainesville, Florida
| | - Brent R Logan
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pintip Chitphakdithai
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Gorgun Akpek
- Banner MD Anderson Cancer Center, Gilbert, Arizona
| | - Paolo Anderlini
- University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Chris Bredeson
- Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada
| | | | - Gregory Hale
- All Children's Hospital, St. Petersburg, Florida
| | - Peiman Hematti
- University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | | | - Rammurti T Kamble
- Baylor College of Medicine Center for Cell and Gene Therapy, Houston, Texas
| | - Hillard M Lazarus
- University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, Ohio
| | | | - Michael A Pulsipher
- University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, Utah
| | - Bipin N Savani
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Bronwen E Shaw
- Anthony Nolan Research Institute, London, United Kingdom
| | - Dennis L Confer
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota; National Marrow Donor Program, Minneapolis, Minnesota
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Golubeva V, Mikhalevich J, Novikova J, Tupizina O, Trofimova S, Zueva Y. Novel cell population data from a haematology analyzer can predict timing and efficiency of stem cell transplantation. Transfus Apher Sci 2014; 50:39-45. [DOI: 10.1016/j.transci.2013.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 11/29/2013] [Accepted: 12/01/2013] [Indexed: 12/26/2022]
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15
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Fadilah SAW, Mohd-Razif MI, Seery ZAZ, Nor-Rafeah T, Wan-Fariza WJ, Habsah A, Leong CF. Predictors of the yield of mobilized peripheral blood CD34+ cells in HLA-matched sibling donor. Transfus Apher Sci 2013; 49:583-9. [PMID: 24012241 DOI: 10.1016/j.transci.2013.07.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 07/23/2013] [Accepted: 07/29/2013] [Indexed: 11/29/2022]
Abstract
We examined the donor factors that may affect the yield of peripheral blood stem cell (PBSC) mobilized from healthy donors. Pre-apheresis PB-CD34(+) cell count was the only factor that correlated with PBSC yield. Leukocyte count (LC) and monocyte count (MC) correlated with PB-CD34(+) cell. Male gender and PB-CD34(+) cell count of at least 87.1/μL and 69.8/μL on day-4 and -5 of G-CSF were associated with the ability to harvest at least 5×10(6)/kg CD34(+) cells after one apheresis. We concluded that gender and PB-CD34(+) cell count are important predictors of PBSC yield. LC and MC may serve as surrogate markers for estimating the PB-CD34(+) cell count.
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Affiliation(s)
- S A W Fadilah
- Cell Therapy Centre, Kuala Lumpur, Malaysia; Department of Medicine, Kuala Lumpur, Malaysia.
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Regenerative Therapies-Trachea. Regen Med 2013. [DOI: 10.1007/978-94-007-5690-8_33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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17
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Factors influencing engraftment in HLA-haploidentical/mismatch related transplantation with combined granulocyte-colony stimulating factor-mobilized peripheral blood and bone marrow for patients with leukemia. Transfus Apher Sci 2011; 44:249-55. [DOI: 10.1016/j.transci.2011.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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18
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Sakashita AM, Kondo AT, Ribeiro AAF, Cipolletta ANF, Colesanti MV, Hamerschlak N, Kutner JM. Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience. EINSTEIN-SAO PAULO 2011; 9:196-200. [PMID: 26760815 DOI: 10.1590/s1679-45082011ao1932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate factors affecting peripheral blood hematopoietic stem cell yield in patients undergoing large-volume leukapheresis for autologous peripheral blood stem cell collection. METHODS Data from 304 consecutive autologous peripheral blood stem cell donors mobilized with hematopoietic growth factor (usually G-CSF), associated or not with chemotherapy, at Hospital Israelita Albert Einstein between February 1999 and June 2010 were retrospectively analyzed. The objective was to obtain at least 2 × 106 CD34+ cells/kg of body weight. Pre-mobilization factors analyzed included patient's age, gender and diagnosis. Post mobilization parameters evaluated were pre-apheresis peripheral white blood cell count, immature circulating cell count, mononuclear cell count, peripheral blood CD34+ cell count, platelet count, and hemoglobin level. The effect of pre and post-mobilization factors on hematopoietic stem cell collection yield was investigated using logistic regression analysis (univariate and multivariate approaches). RESULTS Pre-mobilization factors correlating to poor CD34 + cell yield in univariate analysis were acute myeloid leukemia (p = 0.017) and other hematological diseases (p = 0.023). Significant post-mobilization factors included peripheral blood immature circulating cells (p = 0.001), granulocytes (p = 0.002), hemoglobin level (p = 0.016), and CD34+ cell concentration (p < 0.001) in the first harvesting day. However, according to multivariate analysis, peripheral blood CD34+ cell content (p < 0.001) was the only independent factor that significantly correlated to poor hematopoietic stem cell yield. CONCLUSION In this study, peripheral blood CD34+ cell concentration was the only factor significantly correlated to yield in patients submitted to for autologous collection.
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Affiliation(s)
| | | | | | | | | | | | - Jose Mauro Kutner
- Blood Bank, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, BR
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Immunohematopoietic stem cell transplantation in Cape Town: a ten-year outcome analysis in adults. Hematol Oncol Stem Cell Ther 2010; 2:320-32. [PMID: 20118055 DOI: 10.1016/s1658-3876(09)50020-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Immunohematopoietic stem cell transplantation has curative potential in selected hematologic disorders. Stem cell transplantation was introduced into South Africa in 1970 as a structured experimental and clinical program. In this report, we summarize the demography and outcome by disease category, gender, and type of procedure in patients older than 18 years of age who were seen from April 1995 to December 2002. PATIENTS AND METHODS This retrospective analysis included 247 individuals over 18 years of age for whom complete data were available. These patients received grafts mostly from peripheral blood with the appropriate stem cell population recovered by apheresis. RESULTS Patient ages ranged from 20 to 65 years with a median age of 42 years. There were 101 females and 146 males. There were no withdrawals and 63% survived to the end of the study. At 96 months of follow-up, a stable plateau was reached for each disease category. Median survival was 3.3 years (n=6, 14.6%) for acute lymphoblastic anemia, 3.1 years (n=44, 18%) for acute myeloid leukemia, 2.8 years (n=47, 19%) for chronic granulocytic leukemia, 2.8 years (n=71, 29%) for lymphoma, 1.5 years (n=23, 9%) for myeloma, 1.43 years (n=10, 4%) for aplasia, and 1.4 years (n=38, 15%) for a miscellaneous group comprising less than 10 examples each. Multivariate analysis showed that only diagnosis and age had a significant impact on survival, but these two variables might be interrelated. There was no significant difference in outcome by source of graft. CONCLUSION The results confirm that procedures carried out in a properly constituted and dedicated unit, which meets established criteria and strictly observes treatment protocols, generate results comparable to those in a First World referral center. Low rates of transplant-related mortality, rejection and graft-versus-host disease are confirmed, but the benefits cannot be extrapolated outside of academically oriented and supervised facilities.
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Martín-Antonio B, Carmona M, Falantes J, Gil E, Baez A, Suarez M, Marín P, Espigado I, Urbano-Ispizua A. Impact of constitutional polymorphisms in VCAM1 and CD44 on CD34+ cell collection yield after administration of granulocyte colony-stimulating factor to healthy donors. Haematologica 2010; 96:102-9. [PMID: 20851866 DOI: 10.3324/haematol.2010.026401] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
UNLABELLED Background The number of CD34(+) cells mobilized from bone marrow to peripheral blood after administration of granulocyte colony-stimulating factor varies greatly among healthy donors. This fact might be explained, at least in part, by constitutional differences in genes involved in the interactions tethering CD34(+) cells to the bone marrow. DESIGN AND METHODS We analyzed genetic characteristics associated with CD34(+) cell mobilization in 112 healthy individuals receiving granulocyte colony-stimulating factor (filgrastim; 10 μg/kg; 5 days). RESULTS Genetic variants in VCAM1 and in CD44 were associated with the number of CD34(+) cells in peripheral blood after granulocyte colony-stimulating factor administration (P = 0.02 and P = 0.04, respectively), with the quantity of CD34(+) cells ×10⁶/kg of donor (4.6 versus 6.3; P < 0.001 and 7 versus 5.6; P = 0.025, respectively), and with total CD34(+) cells ×10⁶ (355 versus 495; P = 0.002 and 522 versus 422; P = 0.012, respectively) in the first apheresis. Of note, granulocyte colony-stimulating factor administration was associated with complete disappearance of VCAM1 mRNA expression in peripheral blood. Moreover, genetic variants in granulocyte colony-stimulating factor receptor (CSF3R) and in CXCL12 were associated with a lower and higher number of granulocyte colony-stimulating factor-mobilized CD34(+) cells/μL in peripheral blood (81 versus 106; P = 0.002 and 165 versus 98; P=0.02, respectively) and a genetic variant in CXCR4 was associated with a lower quantity of CD34(+) cells ×10⁶/kg of donor and total CD34(+) cells ×10⁶ (5.3 versus 6.7; P = 0.02 and 399 versus 533; P = 0.01, respectively). Conclusions In conclusion, genetic variability in molecules involved in migration and homing of CD34(+) cells influences the degree of mobilization of these cells.
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Abstract
Transplantation with bone marrow (BM) hematopoietic stem cells (HSC) has been used for curative therapy of hematologic diseases and inborn errors of metabolism for decades. More recently, alternative sources of HSC, particularly those induced to exit marrow and traffic to peripheral blood in response to external stimuli, have become the most widely used hematopoietic graft and show significant superiority to marrow HSC. Although a variety of agents can mobilize stem cells with different kinetics and efficiencies and these agents can be additive or synergistic when used in combination, currently G-CSF is the predominant stem cell mobilizer used clinically based upon potency, predictability and safety. Recent studies have demonstrated that the interaction between the chemokine stromal-derived factor 1 (SDF-1/CXCL12) and its receptor CXCR4 serves as a key regulator of HSC trafficking. AMD3100, a novel bicyclam CXCR4 antagonist, induces the rapid mobilization of HSC with both short- and long-term repopulation capacity. Mobilization with G-CSF and AMD3100 in clinical trials resulted in more patients achieving sufficient PBSC for transplantation than with G-CSF alone. Thus, chemokine axis-mobilization could allow rapid PBSC harvests with increased cell yields in difficult-to mobilize patients. Studies of autologous and allogeneic transplantation of AMD3100 mobilized grafts demonstrated prompt and stable engraftment. Enhanced homing properties of chemokine axis-mobilized PBSC suggest that these cells may have greater therapeutic utility in other areas including tissue repair and regeneration.
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22
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Plerixafor (AMD3100) and granulocyte colony-stimulating factor (G-CSF) mobilize different CD34+ cell populations based on global gene and microRNA expression signatures. Blood 2009; 114:2530-41. [PMID: 19602709 DOI: 10.1182/blood-2009-04-214403] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Plerixafor (AMD3100) and granulocyte colony-stimulating factor (G-CSF) mobilize peripheral blood stem cells by different mechanisms. A rhesus macaque model was used to compare plerixafor and G-CSF-mobilized CD34(+) cells. Three peripheral blood stem cell concentrates were collected from 3 macaques treated with G-CSF, plerixafor, or plerixafor plus G-CSF. CD34(+) cells were isolated by immunoselection and were analyzed by global gene and microRNA (miR) expression microarrays. Unsupervised hierarchical clustering of the gene expression data separated the CD34(+) cells into 3 groups based on mobilization regimen. Plerixafor-mobilized cells were enriched for B cells, T cells, and mast cell genes, and G-CSF-mobilized cells were enriched for neutrophils and mononuclear phagocyte genes. Genes up-regulated in plerixafor plus G-CSF-mobilized CD34(+) cells included many that were not up-regulated by either agent alone. Two hematopoietic progenitor cell miR, miR-10 and miR-126, and a dendritic cell miR, miR-155, were up-regulated in G-CSF-mobilized CD34(+) cells. A pre-B-cell acute lymphocytic leukemia miR, miR-143-3p, and a T-cell miR, miR-143-5p, were up-regulated in plerixafor plus G-CSF-mobilized cells. The composition of CD34(+) cells is dependent on the mobilization protocol. Plerixafor-mobilized CD34(+) cells include more B-, T-, and mast cell precursors, whereas G-CSF-mobilized cells have more neutrophil and mononuclear phagocyte precursors.
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Hacioglu S, Altuntas F, Kaynar L, Sari I, Patiroglu T, Cetin M. Rhabdomyolysis in a Healthy Peripheral Blood Stem Cell Donor following Mobilization with Filgrastim. Transfus Med Hemother 2009; 36:135-137. [PMID: 20823994 PMCID: PMC2928827 DOI: 10.1159/000206822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 12/12/2008] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND: Although granulocyte colony stimulating factor (G-CSF) mobilization is generally well tolerated by healthy donors, there is also a wide spectrum of adverse events associated with it. Among these events, rhabdomyolysis in peripheral blood stem cell (PBSC) donors is very rare. In this paper, we present a first case of rhabdomyolysis after administration of filgrastim for PBSC mobilization. CASE REPORT: A 6-year-old donor received 10 mug/kg/day filgrastim subcutaneously for 5 days. On the 3rd day of filgrastim, the donor complained of bone pain; a single dose of paracetamol (250 mg) was given to relieve pain. On the 4th day, she complained of bone pain, myalgia, and vomiting. On laboratory analysis, serum creatine phosphokinase was 1,095 U/l (40-226 U/l), LDH 312 U/l (100-190 U/l), aspartate aminotransferase 85 U/l (0-40 U/l), potassium 3.3 mmol/l (3.6-5.1 mmol/l). Urine myoglobin was 110 ng/ml (<5 ng/ml). Rhabdomyolysis was suspected on clinical and laboratory findings. Clinical manifestations regressed and the laboratory results returned to normal within three days after intravenously forced diuresis and potassium replacement. Stem cells were successfully harvested from peripheral blood on the 5th day of G-CSF therapy. CONCLUSION: Rhabdomyolysis is a rare but important adverse effect of G-CSF. Allogeneic PBSC donors should be closely monitored with regard to rhabdomyolysis after G-CSF administration in the mobilization setting.
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Affiliation(s)
- Sibel Hacioglu
- Department of Hematology, Pamukkale Medical School, Denizli, Kayseri, Turkey
| | - Fevzi Altuntas
- Department of Hematology and Apheresis Unit, Erciyes Medical, Kayseri, Turkey
- *Fevzi Altuntas, MD Department of Hematology and Apheresis Unit Erciyes Medical School 38039 Kayseri, Turkey Tel. +90 352 437-4937, Fax -9348
| | - Leylagul Kaynar
- Department of Hematology and Apheresis Unit, Erciyes Medical, Kayseri, Turkey
| | - Ismail Sari
- Department of Hematology, Pamukkale Medical School, Denizli, Kayseri, Turkey
| | - Turkan Patiroglu
- Department of Pediatric Hematology, Erciyes Medical School, Kayseri, Turkey
| | - Mustafa Cetin
- Department of Hematology and Apheresis Unit, Erciyes Medical, Kayseri, Turkey
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Wang TF, Wen SH, Chen RL, Lu CJ, Zheng YJ, Yang SH, Chu SC, Kao RH, Chen SH. Factors associated with peripheral blood stem cell yield in volunteer donors mobilized with granulocyte colony-stimulating factors: the impact of donor characteristics and procedural settings. Biol Blood Marrow Transplant 2008; 14:1305-11. [PMID: 18940686 DOI: 10.1016/j.bbmt.2008.09.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Accepted: 09/03/2008] [Indexed: 11/29/2022]
Abstract
Peripheral blood stem cells (PBSCs) are increasingly used as the source of hematopoietic stem cells, but there are large variations in harvest outcome between individuals mobilized by granulocyte colony-stimulating factor (G-CSF). We examined the effects of donor characteristics and procedure factors on the day 1 CD34+ cell yield in 373 unrelated healthy donors. G-CSF was administered subcutaneously at a planned dose of 8.3 to 11 microg/kg daily for 5 days, followed by harvest started on day 5 of G-CSF treatment. Of the 373 donors, 159 (42.6%) had the radial artery as the inlet access for harvest. Poor day 1 cell yield was defined as <10x10(6) CD34+ cells/L of processed blood for the first apheresis; 62 donors (16.6%) did not attain this threshold. The male donors had significantly higher yields at harvest compared with the female donors. The female donors had higher CD34+ cell yields if the circulation access was through an artery than if is was through a vein. In a multiple regression analysis, donor age, sex, body mass index (BMI), preharvest white blood cell and circulating immature cell counts, access type, and flow rate correlated with day 1 yield. Female sex, older age, venous access, and a higher flow rate were significantly associated with greater risk for a day 1 poor yield of CD34+ cells (odds ratio=3.0074, 1.045, 4.3362, and 1.1131, respectively). A higher BMI may decrease the risk (odds ratio=0.8472). In donors at higher risk for poor CD34+ cell yield, strategies for increasing CD34+ cells must be considered.
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Affiliation(s)
- Tso-Fu Wang
- Department of Hematology and Oncology, Tzu-Chi General Hospital, and Department of Public Health, College of Medicine, Tzu-Chi University, Hualien, Taiwan
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Donor demographic and laboratory predictors of allogeneic peripheral blood stem cell mobilization in an ethnically diverse population. Blood 2008; 112:2092-100. [PMID: 18523146 DOI: 10.1182/blood-2008-03-143677] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A reliable estimate of peripheral blood stem cell (PBSC) mobilization response to granulocyte colony-stimulating factor (G-CSF) may identify donors at risk for poor mobilization and help optimize transplantation approaches. We studied 639 allogeneic PBSC collections performed in 412 white, 75 black, 116 Hispanic, and 36 Asian/Pacific adult donors who were prescribed G-CSF dosed at either 10 or 16 microg/kg per day for 5 days followed by large-volume leukapheresis (LVL). Additional LVL (mean, 11 L) to collect lymphocytes for donor lymphocyte infusion (DLI) and other therapies was performed before G-CSF administration in 299 of these donors. Day 5 preapheresis blood CD34(+) cell counts after mobilization were significantly lower in whites compared with blacks, Hispanics, and Asian/Pacific donors (79 vs 104, 94, and 101 cells/microL, P < .001). In addition, donors who underwent lymphapheresis before mobilization had higher CD34(+) cell counts than donors who did not (94 vs 79 cells/microL, P < .001). In multivariate analysis, higher post-G-CSF CD34(+) cell counts were most strongly associated with the total amount of G-CSF received, followed by the pre-G-CSF platelet count, pre-G-CSF mononuclear count, and performance of prior LVL for DLI collection. Age, white ethnicity, and female gender were associated with significantly lower post-G-CSF CD34(+) cell counts.
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Tijssen MR, Woelders H, de Vries-van Rossen A, van der Schoot CE, Voermans C, Lagerberg JWM. Improved postthaw viability and in vitro functionality of peripheral blood hematopoietic progenitor cells after cryopreservation with a theoretically optimized freezing curve. Transfusion 2008; 48:893-901. [PMID: 18298597 DOI: 10.1111/j.1537-2995.2008.01650.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The freezing curve currently used for the cryopreservation of peripheral blood stem cell transplants (PBSCTs) has been determined empirically. Although the use of cryopreserved PBSCTs is successful and usually leads to rapid hematopoietic recovery, the freeze-thawing process is known to induce a significant degree of cell death. Furthermore, the infusion of dimethyl sulfoxide (DMSO), used to protect the cells against damage induced by freezing, can cause morbidity. Therefore, optimizing the current cryopreservation protocol (with 10% DMSO and a slow linear cooling curve) with theoretically optimized freezing curves and a lower DMSO concentration might improve the recovery after transplantation. STUDY DESIGN AND METHODS A theoretical model was used to predict optimal freezing curves for 5 and 10 percent DMSO. CD34+-selected and -unselected PBSCs were cryopreserved with the current or the new freezing curves. Postthaw quality was evaluated by cell viability, colony formation, and megakaryocyte outgrowth. RESULTS With 10 percent DMSO, the use of the predicted optimal freezing curve resulted in increased postthaw viability of CD34+ cells, colony formation, and megakaryocyte outgrowth. Lowering the DMSO concentration to 5 percent resulted in improved postthaw viability and functionality, which was not further improved by use of the theoretically optimized freezing curve. CONCLUSIONS Our results indicate that the current cryopreservation method for PBSCTs can be improved by either lowering the DMSO concentration to 5 percent or by using the theoretically optimized freezing curve. Infusion of less DMSO and more viable cells might improve the outcome of PBSCT.
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Affiliation(s)
- Marloes R Tijssen
- Department of Experimental Immunohematology and Blood Cell Research, Laboratory of Cryobiology, Sanquin Research, Amsterdam, The Netherlands
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Divani AA, Hussain MS, Magal E, Heary RF, Qureshi AI. The Use of Stem Cells’ Hematopoietic Stimulating Factors Therapy Following Spinal Cord Injury. Ann Biomed Eng 2007; 35:1647-56. [PMID: 17641973 DOI: 10.1007/s10439-007-9359-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 07/13/2007] [Indexed: 11/29/2022]
Abstract
Spinal cord injury (SCI) remains one of the most devastating conditions in medicine, particularly due to the loss of productive life years and the high economic burden it places on our society. There are limited therapeutic options available to reduce the morbidity and mortality related to SCI. However, recent work with stem cells in repairing SCI appears to be promising, making this one of the most exciting frontiers in medicine. A brief review of the mechanisms of SCI is presented. Stem cells from a variety of sources have shown effectiveness in improving motor function after SCI in animals. The pre-clinical use of stem cells in SCI and methods of delivery are discussed. The potential use of granulocyte-colony stimulating factor (G-CSF) to increase the number of stem cells engrafting at the site of injury in order to improve neurological and motor function recovery following SCI is introduced. G-CSF, through stimulation of lymphohemopoietic stem cells in peripheral blood, can potentially cause repopulation of the SCI region with neural progenitor cells. This allows for improved functional outcomes. More pre-clinical and translational research exploring this possibility is required.
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Affiliation(s)
- Afshin A Divani
- Department of Neurology and Neurosciences, UMDNJ, New Jersey Medical School, Zeenat Qureshi Stroke Research Center, Newark, NJ 07103, USA.
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Zaldivar F, Eliakim A, Radom-Aizik S, Leu SY, Cooper DM. The effect of brief exercise on circulating CD34+ stem cells in early and late pubertal boys. Pediatr Res 2007; 61:491-5. [PMID: 17515877 DOI: 10.1203/pdr.0b013e3180332d36] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
We tested the hypothesis that exercise could stimulate CD34+ peripheral blood hematopoietic stem cells (PBSC) in children. Fourteen early pubertal boys (EP, age 10.3 +/- 0.3 y) and 13 late pubertal boys (LP, age 16.5 +/- 0.4 y) performed 20 min of moderate-to-vigorous cycle ergometer exercise. Blood was drawn before and after exercise. Cells were stained for surface CD34+. Plasma granulocyte colony stimulating factor (G-CSF), Fms-like tyrosine kinase-3 (FLT-3), and stromal cell-derived factor-1 (SDF-1) were measured using ELISA. Exercise substantially increased PBSC (in EP from 112 +/- 21 to 182 +/- 30 cells/microL, p=0.0007; in LP from 63 +/- 8 to 152 +/- 21, p=0.0008), and to a smaller extent FLT-3 (in EP from 98 +/- 5 to 110 +/- 6 pg/mL, p<0.0001; in LP from 73 +/- 6 to 92 +/- 6, p<0.0001) and G-CSF (in EP from 26 +/- 4 to 29 +/- 4 pg/mL, p<0.0001; in LP from 14 +/- 1 to 18 +/- 1, p<0.0001). Baseline levels of PBSC, FLT-3, and G-CSF were significantly higher in EP. Exercise increased SDF-1 alpha only in LP, and the FLT-3 increase was greater in LP than EP. Brief exercise affects PBSC and PBSC mediators in children.
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Affiliation(s)
- Frank Zaldivar
- Pediatric Exercise Research Center, Department of Pediatrics, University Children's Hospital, University of California Irvine, Orange, CA 92868, USA
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29
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Abstract
Extramedullary proliferations of bone marrow elements are infrequently encountered in routine pathology practice. On occasion, they can present diagnostic difficulties when seen in unusual or unanticipated sites. This review serves to cover aspects of underlying embryogenesis of myeloid elements, as well as sites and circumstance of benign proliferations of myeloid elements along with their occasional confusion with neoplastic myeloid proliferations. Benign proliferations associated with hematologic disorders and hematopoietic growth factors are discussed. Immunohistochemical evaluation of myeloid proliferations is considered as well.
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30
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Gol’dberg ED, Dygai AM, Zhdanov VV, Vetoshkina TV, Gur’yantseva LA, Dubskaya TY, Ermolaeva LA, Zyuz’kov GN, Simanina EV, Sotnikova NV, Stavrova LA, Udut EV, Fomina TI, Khrichkova TY. Creation of experimental models and study of the regeneratory potential of stem cells on these models. Bull Exp Biol Med 2007. [DOI: 10.1007/s10517-007-0069-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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31
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Tijssen MR, van der Schoot CE, Voermans C, Zwaginga JJ. Clinical approaches involving thrombopoietin to shorten the period of thrombocytopenia after high-dose chemotherapy. Transfus Med Rev 2006; 20:283-93. [PMID: 17008166 DOI: 10.1016/j.tmrv.2006.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
High-dose chemotherapy followed by a peripheral blood stem cell transplant is successfully used for a wide variety of malignancies. A major drawback, however, is the delay in platelet recovery. Several clinical strategies using thrombopoietin (Tpo) have been developed in an attempt to speed up platelet repopulation. In contrast to its success in immune thrombocytopenia and in low-dose toxic chemotherapeutic regimens, Tpo appears less effective in the case of high-dose chemotherapy and peripheral blood stem cell transplant. To develop a successful therapeutic approach, more knowledge is needed on several aspects of megakaryocyte (progenitor) biology, such as homing to the bone marrow, endomitosis, and platelet formation. Interactions of the megakaryocytes with the marrow vasculature and the microvascular microenvironment are other key factors for optimal thrombocytopoiesis. The present report reviews the background of the inefficiency of Tpo after intensive chemotherapy and describes possible strategies that might lead to successful therapies to treat chemotherapy-induced thrombocytopenia.
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Affiliation(s)
- Marloes R Tijssen
- Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands
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Leung KN, Mak NK, Fung MC. Cytokines in the differentiation therapy of leukemia: from laboratory investigations to clinical applications. Crit Rev Clin Lab Sci 2006; 42:473-514. [PMID: 16390682 DOI: 10.1080/10408360500295154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Differentiation therapy of leukemia is the treatment of leukemia cells with biological or chemical agents that induce the terminal differentiation of the cancer cells. It is regarded as a novel and targeted approach to leukemia treatment, based on our better understanding of the hematopoietic process and the mechanisms of its deregulation during leukemogenesis. Clinically, differentiation therapy has been most successful in acute promyelocytic leukemia using all-trans-retinoic acid as the inducer, either alone or in combination with chemotherapy. This review presents evidence that a number of hematopoietic cytokines play important roles in both normal and aberrant hematopoietic processes. In vitro laboratory investigations in the past two decades using well-characterized myeloid leukemic cell lines and primary blast cells from leukemia patients have revealed that many hematopoietic cytokines can trigger lineage-specific differentiation of leukemia cells, which may have important implications in the clinical setting. Moreover, our current understanding of cytokine interactions and the molecular mechanisms of cytokine-induced leukemic cell differentiation will be discussed in the light of recent findings. Finally, ways in which laboratory research on cytokines in the differentiation therapy of leukemia can lead to the improved design of protocols for future clinical applications to leukemia therapy will also be addressed.
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Affiliation(s)
- K N Leung
- Department of Biochemistry, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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33
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Hosing C, Qazilbash MH, Kebriaei P, Giralt S, Davis MS, Popat U, Anderlini P, Shpall EJ, McMannis J, Körbling M, Champlin RE. Fixed-dose single agent pegfilgrastim for peripheral blood progenitor cell mobilisation in patients with multiple myeloma. Br J Haematol 2006; 133:533-7. [PMID: 16681642 DOI: 10.1111/j.1365-2141.2006.06054.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
High-dose chemotherapy and autologous peripheral blood progenitor cell transplantation is an effective treatment for multiple myeloma. Progenitor cells are generally mobilised into the peripheral blood by administration of filgrastim. Pegfilgrastim is a covalent conjugate of filgrastim with a longer half-life. The results of a phase II study of pegfilgrastim, administered as a single injection to mobilise autologous peripheral blood progenitor cells in patients with multiple myeloma, is reported. All patients (n = 19) received 12 mg of pegfilgrastim. Leukaphaeresis was started when the peripheral blood CD34(+) count was >0.015 x 10(9)/l. Daily, leukaphaeresis was performed until the target progenitor cell dose was obtained. The median number of leukaphaeresis procedures required to collect the target CD34(+) cell dose was 2 (range 1-5). A median of 8.4 x 10(6) CD34(+) cells/kg (range 4.1-15.8) was collected. The most common toxicity was bone pain/myalgia. Sustained haematological recovery occurred in all the patients who underwent high-dose chemotherapy followed by autologous peripheral blood progenitor cell transplantation with pegfilgrastim-mobilised cells. A single fixed dose of pegfilgrastim was effective in mobilising adequate peripheral blood progenitor cells in patients with multiple myeloma. The efficacy and toxicity profile was similar to that described with filgrastim treatment.
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Affiliation(s)
- Chitra Hosing
- Department of Blood and Marrow Transplantation, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
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34
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Lee JS, Jung HJ, Park JE. The Correlation between G-CSF Dosage and the Number of Collected CD34+ Cells in Pediatric Patients Undergoing Peripheral Blood Stem Cell Mobilization. THE KOREAN JOURNAL OF HEMATOLOGY 2006. [DOI: 10.5045/kjh.2006.41.4.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ji Sook Lee
- Department of Pediatric Hematology-Oncology, School of Medicine, Ajou University, Suwon, Korea
| | - Hyun Joo Jung
- Department of Pediatric Hematology-Oncology, School of Medicine, Ajou University, Suwon, Korea
| | - Jun Eun Park
- Department of Pediatric Hematology-Oncology, School of Medicine, Ajou University, Suwon, Korea
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35
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Lyman GH. Pegfilgrastim: a granulocyte colony-stimulating factor with sustained duration of action. Expert Opin Biol Ther 2005; 5:1635-46. [PMID: 16318427 DOI: 10.1517/14712598.5.12.1635] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Granulocyte colony-stimulating factors such as filgrastim (Neupogen, Amgen, Inc.) and pegfilgrastim (Neulasta, Amgen, Inc.) are frequently used in clinical practice for the prevention of chemotherapy-induced neutropenia and its potentially life-threatening complications. Due to its unique neutrophil-mediated clearance, pegfilgrastim can be administered once per chemotherapy cycle. Clinical trials have shown that a single, fixed subcutaneous dose of pegfilgrastim 6 mg is comparable in safety and efficacy to daily injections of filgrastim for decreasing the incidence of infection following myelosuppressive chemotherapy in patients with cancer. Postregistrational trials have been conducted to evaluate the use of pegfilgrastim with emerging dose-dense regimens, in myeloid cancers and for mobilisation and engraftment of autologous stem cells. Ongoing clinical trials continue to explore further potential uses for pegfilgrastim.
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Affiliation(s)
- Gary H Lyman
- James P Wilmot Cancer Center, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, New York 14642, USA.
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Suzuya H, Watanabe T, Nakagawa R, Watanabe H, Okamoto Y, Onishi T, Abe T, Kawano Y, Kagami S, Takaue Y. Factors associated with granulocyte colony-stimulating factor-induced peripheral blood stem cell yield in healthy donors. Vox Sang 2005; 89:229-35. [PMID: 16262756 DOI: 10.1111/j.1423-0410.2005.00701.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Poor collection results are a clinical problem in granulocyte-colony stimulating factor (G-CSF)-induced peripheral blood stem cell (PBSC) collection in healthy donors. It would be beneficial to be able to predict the PBSC yield from allogeneic donors before mobilization or harvesting. MATERIALS AND METHODS We examined the relationship between certain donor characteristics and the effectiveness of G-CSF-induced PBSC collection in 59 healthy family donors aged 3-63 years old (median 16 years). G-CSF was administered subcutaneously at 10 microg/kg for mobilization, daily for 5 days, and PBSC harvest using a continuous blood cell separator was started on day 5 of G-CSF treatment. Total cell yields were calculated as the number per unit of processed blood (l) per unit weight of the donor (kg). RESULTS In a univariate analysis, the donor's age, body mass index (BMI), white blood cell (WBC) count before mobilization, and platelet count before and during mobilization were significantly correlated with the yield of mononuclear cells (MNC), CD34(+) cells and granulocyte-macrophage colony-forming units (GM-CFU). Younger age (P < 0.001), a low BMI (P = 0.002), a high WBC count before mobilization (P = 0.004), a high platelet count before (P = 0.012) and during (P < 0.05) mobilization, and a low speed of withdrawal (P = 0.019) were associated with a higher CD34(+) cell yield. No significant correlation was found for gender, the type of G-CSF, the serum level of G-CSF, the type of cell separator, or the type of blood access. A multivariate forward and backward stepwise selection regression analysis showed that the factors associated with CD34(+) cell yield were age, platelet count before and during mobilization, and circulating CD34(+) cell concentration on day 2 of G-CSF treatment. CONCLUSION In this small preliminary study, we found that donor age is the most important factor in predicting G-CSF-induced PBSC yields. Old age and low platelet counts before mobilization might be useful indicators for identifying poor mobilizers. Further validation of these findings in a larger number of donors are needed to establish whether these findings apply to other populations.
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Affiliation(s)
- H Suzuya
- Department of Pediatrics, University of Tokushima Graduate School of Medical Science, Tokushima, Japan
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