Mobilization effects of G-CSF, GM-CSF, and darbepoetin-α for allogeneic peripheral blood stem cell transplantation

• Published in: Journal of clinical apheresis 2009, Vol.24 (5), p.173-179
• Main Authors: Kim, Shi Nae, Moon, Joon Ho, Kim, Jong Gwang, Chae, Yee Soo, Cho, Yoon Young, Lee, Soo Jung, Kim, Yun Jeong, Lee, Yoo Jin, Suh, Jang Soo, Lee, Kun Soo, Sohn, Sang Kyun
• Format: Article
• Language: English
• Subjects: Adjuvants, Immunologic - administration & dosage; Adult; Aged; colony-stimulating factor; Darbepoetin alfa; darbepoetin-α; Erythropoietin - administration & dosage; Erythropoietin - analogs & derivatives; Female; Granulocyte Colony-Stimulating Factor - administration & dosage; Granulocyte-Macrophage Colony-Stimulating Factor - administration & dosage; Hematinics - administration & dosage; Hematopoietic Stem Cell Mobilization; Humans; Leukocyte Count; Male; Middle Aged; mobilization; Peripheral Blood Stem Cell Transplantation; Recombinant Proteins - administration & dosage; Recovery of Function; Stem Cells - cytology; Transplantation, Homologous
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.20207

The effects of GM‐/G‐CSF and darbepoetin‐α on stem cell mobilization were investigated. From February 2005 to March 2007, 30 allogeneic sibling donors were randomly assigned to a G‐CSF group (5 μg/kg/day for 5–7 days) or triple group (GM‐CSF 10 μg/kg/day on 1st and 2nd day, G‐CSF 5 μg/kg/day for 5–7 days, and darbepoetin‐α 40 mg on 1st day). The MNCs and CD34+ cells were not different between the two groups, although the doses (×108/kg of recipient body weight) of CD3+ cells (3.64 ± 1.75 vs. 2.63 ± 1.36, P = 0.089) and CD8+ cells (1.07 ± 0.53 vs. 0.60 ± 0.30, P = 0.006) were lower in the triple group. The engraftments, frequency of RBC transfusions, and hemoglobin recovery were not different between the two groups. The cumulative incidence of overall and Grades II–IV aGVHD was 64.3% vs. 61.1% and 25.9% vs. 27.1% in the G‐CSF and triple regimen group, respectively, whereas the cumulative incidence of cGVHD was 20.8 ± 1.3% and 24.4 ± 1.7%, respectively. In conclusion, the triple regimen did not seem to be superior to G‐CSF alone in terms of the CD34+ cell dose, hemoglobin recovery, and GVHD. However, the CD8+ cell count was significantly lower in the triple regimen group. The role of a lower CD8+ cell count in the graft may need to be elucidated in the future. J. Clin. Apheresis, 2009. © 2009 Wiley‐Liss, Inc.