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Kinetics of G–CSF and CD34+ cell mobilization after once or twice daily stimulation with rHu granulocyte‐stimulating factor (lenograstim) in healthy volunteers: an intraindividual crossover study
Author(s) -
Kröger Nicolaus,
Sonnenberg Stefan,
CortesDericks Lourdes,
Freiberger Petra,
Mollnau Hanke,
Zander Axel R.
Publication year - 2004
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.0041-1132.2004.00618.x
Subject(s) - granulocyte colony stimulating factor , crossover study , medicine , stimulation , granulocyte , mobilization , immunology , chemotherapy , placebo , archaeology , history , alternative medicine , pathology
BACKGROUND: G–CSF given as split dose increased the harvested number of CD34+ cells in comparison to a once daily schedule, but the mechanism is poorly understood. STUDY DESIGN AND METHODS: To investigate the schedule dependency of G–CSF in healthy volunteers with respect to CD34+ cell mobilization, the same dose of G–CSF was applied in four healthy volunteers in two different schedules (once daily vs. split doses twice daily) in a crossover design after a washout period of 3 months. CD34+ cell kinetics in serum were determined as well as G–CSF serum kinetics on Days 1 and 4 after stimulation. RESULTS: In all volunteers, the twice daily schedule led to a higher CD34+ cell count after 4 days of G–CSF stimulation (median, 94.5 vs. 47/µL; p = 0.05). On Days 1 and 4, there was a higher peak serum concentration of G–CSF serum level after the once daily application (15,175 vs. 6,859 pg/mL and 7440 vs. 2388 pg/mL, respectively) than after the twice daily schedule. In contrast, after the once daily application the minimum serum level of G–CSF serum level was lower than after the twice daily schedule (663 vs. 1361 pg/mL and 246 vs. 441 pg/mL, respectively). No difference of area under the curve for G–CSF was observed on Days 1 and 4 after G–CSF stimulation. CONCLUSION: It is suggested that application of G–CSF twice daily leads to a higher CD34+ cell mobilization owing to a higher minimum serum level and therefore to a more continuous serum baseline level resulting in a more efficient CD34+ cell mobilization.