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Equivalent mobilization and collection of granulocytes for transfusion after administration of glycosylated G–CSF (3 μg/kg) plus dexamethasone versus glycosylated G–CSF (12 μg/kg) alone
Author(s) -
Heuft H.G.,
Goudeva L.,
Sel S.,
Blasczyk R.
Publication year - 2002
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.2002.00133.x
Subject(s) - apheresis , medicine , dexamethasone , regimen , adverse effect , granulocyte colony stimulating factor , gastroenterology , urology , platelet , chemotherapy
BACKGROUND : The aim of this study was to find a regimen for mobilization and collection of granulocytes that combines low‐dose G–CSF administration with satisfactory PMN mobilization and apheresis at a low rate of donor adverse reactions. STUDY DESIGN AND METHODS : In a prospective study, 52 healthy unrelated volunteers received a single subcutaneous injection of glycosylated G–CSF (Lenograstim Chugai‐Pharma, Frankfurt, Germany) at medians of 3.1 (range, 2.4‐3.6) μg per kg plus dexamethasone (8 mg orally; n = 29) or at 11.8 (7.1‐18.5) μg of lenograstim per kg (p ≤ 0.0001) without dexamethasone (n = 23) and underwent standard apheresis using the PMN program of a cell separator (Spectra, COBE [now Gambro] BCT). WBC and PMN mobilization results and apheresis yields were compared and the severity and clinical significance of donor adverse reactions was evaluated. RESULTS : For the low‐dose G–CSF plus dexamethasone versus the high‐dose G–CSF alone group, similar mobilization results were observed for WBCs with 31.3 (19.1‐44.9) × 10 9 per L versus 27.5 (19.2‐44.0) × 10 9 per L (p = 0.21, NS) and PMNs with 29.0 (17.6‐42.2) × 10 9 per L versus 25.2 (16.2‐39.0) × 10 9 per L (p = 0.08, NS). The PMN apheresis yields were equal with 70 (39‐139) × 10 9 per unit with low‐dose G–CSF versus 68 (33‐120) × 10 9 per unit in the high‐dose G–CSF group (p = 0.83, NS). Regarding donor adverse reactions, 7 out of 29 (24%) and 8 out of 23 donors (35%) reported moderate or severe symptoms. The character of these reactions was different; symptoms of greater clinical significance and a higher need for analgesics were observed in the high‐dose G–CSF group. CONCLUSIONS : A Lenograstim dose of 3 μg per kg plus DXM assures effective PMN mobilization and acceptable apheresis components. The combination of glycosylated G–CSF with DXM allows a significant dose reduction in G–CSF for PMN mobilization and collection as compared with higher G–CSF doses alone. In the high‐dose G–CSF mobilization group, adverse reactions were more severe and required more analgesics.