Open AccessPB2335 COMPARISON BETWEEN FOUR AND FIVE DAYS OF G‐CSF‐INDUCED MOBILIZATION IN ALLOGENEIC STEM CELL DONORS
Author(s) -
Moro F. Martin,
Prieto C. Jiménez,
García I. García,
Rupérez A. Sanz,
González S. López,
Fernández B. Michael,
Marín A. J. Saez,
Stock C. NúñezTorrón,
Abia A. Luna,
Núñez M. Tenorio,
Martín A. Jiménez,
Palomanes J. Marquet,
Rodríguez A. Chinea,
Puente P. Herrera,
Gutiérrez V. García,
Jiménez J. López,
Jiménez G. Moreno
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000567804.52587.b4
Subject(s) - medicine , filgrastim , apheresis , granulocyte colony stimulating factor , stem cell , transplantation , mobilization , cd34 , immunology , chemotherapy , platelet , biology , history , archaeology , genetics
Background: Peripheral blood stem cells (PBSC) used for allogenic transplantation (SCT) are collected by apheresis after donors treatment with G‐CSF. It was studied whether collection on the 4 th day instead of the 5 th day after initiation of G‐CSF treatment might be feasible, which reduces exposure to the drug and potential adverse effects associated with its administration in healthy donors. Aims: To compare feasibility and effectiveness of Day 4 mobilization versus Day 5 in allogeneic stem cell donors. Methods: We performed a restrospective single‐center study. Stem cell donors were stimulated with subcutaneous injections of 5 μg G‐CSF (filgrastim)/kg body weight (BW) twice daily. The CD34+ target was 5 × 10 6 /kg recipient BW for haploidentical SCT (haplo‐SCT) and 4 × 10 6 /kg for both HLA‐matched related donors (MRD) and unrelated donors (UD) SCT. PBSC collection was performed with the Spectra Optia. Mobilization on Day 5 was performed during 2016‐2017 and on Day 4 since 2018. CD34+ cells were counted in pre and postapheresis peripheral blood and product samples respectively by flow cytometry using a single‐platform assay. We applied means of descriptive statistics, χ 2 test and Student's t‐test for comparisons, regression analysis and Pearson correlation coefficient (IBM SPSS Statistics 22). Results: We analyzed 87 PBSC allogeneic procedures: 45 (51.7%) performed on the 4 th day of mobilization and 42 (48.3%) on the 5 th day. Both apheresis groups were comparable with regard to donor and recipient characteristics (table 1). Distribution of SCT types was similar in both groups: MRD 23 (51.1%) vs 17 (40.5%), UD 8 (17.8%) vs 10 (23.8%) and haplo 14 (31.1%) vs 15 (35.7%) respectively for Day 4 and Day 5 (p = 0.59). We found no differences in G‐CSF‐related adverse effects nor in apheresis collection procedures between both groups. G‐CSF global treatment price difference between 4 days and 5 days was 1,355€ (11,360€ vs 12,715€; p < 0.001). Correlation between PBSC pre‐apheresis and post‐apheresis sample CD34+ cell count (/μl) of each group is presented in Figure 1. The CD34+ cells count in post‐apheresis products did not differ between Day 4 and Day 5 groups (table 1). Donors who failed the CD34+ target quantity on first apheresis (7/45 of Day 4 and 6/42 of Day 5) reached it on a second procedure; no donor received plerixafor. Main charasteristics are summarized in table 1. Summary/Conclusion: Our results suggest that apheresis on the 4 th day of low‐dose G‐CSF‐induced mobilization in allogeneic stem cell donors is as feasible and effective as collection on Day 5, reducing G‐CSF exposure to healthy donors and global costs.