Abstract
Background:
Between January 1995 and July 2004, mobilisation and harvest of peripheral blood stem cells for allogeneic transplantation was performed in 136 related and 51 unrelated healthy donors. Four related and one unrelated donor were harvested on two separate occasions after renewed G-CSF mobilisation. For logistic reasons, automated harvest programs were used until recently. Automated apheresis programs for peripheral blood stem cell harvest are less labour intensive but unfortunately also less efficient. One of the potential health hazards for donors is the depletion of platelets, thus it is essential to minimize platelet depletion.
Method:
Between 1995 and 1999 CS3000 (Baxter) cell separator with an automated stem cell harvest program was used. Since 1995 Cobe Spectra (Gambro) cell separator is used, initially with the automated program AutoPBSC and since March 2004 with the “manual” program MNC. The 187 medical reports were analysed retrospectively.
Results:
Median age was 40 years (range 14–71), median weight was 75 kg (range 42–130) and the male/female ratio was 1.3 (107/80). In a majority of donors (97%) antecubital veins were used as access to the circulation. In 4% of donors antecubital veins were unsuitable, and a femoral catheter was therefore employed.
Donors were mobilised with G-CSF 10 ug/kg and harvested on days five and six. Transplantation dose was median 6,3 x 10(6) CD34+ cells/kg recipient (range 1,2–98,6). Harvest yield was median 5,8 x 10(6) CD34+ cells/kg donor (range 1,4–16,3). Donor platelet count after second apheresis was median 129 x 10(9)/L (range 57–268) (normal range 150–400).
There were no significant differences regarding yield of CD34+ cells between male and female donors or between the two automated apheresis programs CS3000 and CobeSpectra AutoPBSC but the shift to CobeSpectra MNC-program led to a significantly increased yield only after six (three male and three female) donors (Mann-Whitney Test p<0,005) and median yield doubled to 10 x 10(6) CD34+ cells/kg donor.
There was no significant difference between CS3000 and Cobe Spectra MNC regarding platelet depletion but Cobe Spectra AutoPBSC was significantly less platelet depleting compared both to CS3000 (Mann-Whitney Test p<0,001) and Cobe Spectra MNC (Mann-Witney Test p<0,001).
Conclusion:
No serious side effects were reported during G-CSF mobilisation or apheresis. Cobe Spectra MNC program is significantly more efficient regarding yield of CD34+ cells than the two automated programs. Cobe Spectra AutoPBSC is significantly less platelet depleting than both CS3000 and Cobe Spectra MNC.
A Randomized Controlled Trial to Compare Once- versus Twice-Daily Filgrastim for Mobilization of Peripheral Blood Stem Cells from Healthy Donors
