Stem cell mobilization by G-CSF in solid and hematological malignancies: Single daily dose is better than split dose in obese patients

• Published in: Journal of clinical apheresis 2003, Vol.18 (3), p.120-124
• Main Authors: Çetin, Türker, Arpaci, Fikret, Özet, Ahmet, Öztürk, Bekir, Kömürcü, Şeref, İhsan Uzar, Ali, Yilmaz, İlker, Beyzadeoĝlu, Murat, Oysul, Kaan, Ataergin, Selmin, Kuzhan, Okan, Pekel, Aysel
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antigens, CD34 - biosynthesis; autologous stem cell transplantation; Biological and medical sciences; Blood Component Removal - methods; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; body mass index; body weight; Female; granulocyte colony-stimulating factor; Granulocyte Colony-Stimulating Factor - metabolism; Hematologic Neoplasms - therapy; Hematopoietic Stem Cell Mobilization - methods; Humans; leukapheresis; Male; Medical sciences; Middle Aged; Neoplasms - metabolism; Obesity - complications; peripheral blood progenitor cell mobilization; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.10068

In the past, variable results were reported for single daily and two divided daily doses of granulocyte colony‐stimulating factor (G‐CSF) in stem cell collection where no study exists investigating the effect of body mass index (BMI) on mobilization. The numbers of CD34+ cells collected were compared in 86 patients with solid or hematological malignancies receiving either single daily (14 μg/kg/day) G‐CSF (filgrastim) as group I (n=36) or two divided doses of G‐CSF daily (2 × 7 μg/kg/day) as group II (n = 50). Both groups were divided into subgroups according to their BMI as group a (BMI ≤25 kg/m2) and group b (BMI >25 kg/m2). Two groups were similar in terms of BMI, gender, and disease characteristics. All patients have received G‐CSF as a single or two divided doses subcutaneously and aphereses have been done on the 5th day. No significant difference in numbers of CD34+ cells between groups Ia and Ib, groups IIa and IIb, and groups Ia and IIa was found. On the other hand, the mean ratio and the number of CD34+ cells in group Ib were significantly higher than those of group IIb (0.58 ± 0.06% vs. 0.37 ± 0.26%, P = 0.01 and 3.67 ± 0.65 × 104/kg/ml vs. 1.92 ± 0.37 × 104/kg/ml, P= 0.02). In conclusion, in patients with BMI >25 kg/m2, once daily G‐CSF compared to split dose administration induces a greater number of CD34+ stem cell mobilization, which suggests the presence of a different pharmacokinetics in obese patients. J. Clin. Apheresis 18:120–124, 2003. © 2003 Wiley‐Liss, Inc.