Journal
BLOOD ADVANCES
Volume 4, Issue 4, Pages 706-716Publisher
ELSEVIER
DOI: 10.1182/bloodadvances.2019000923
Keywords
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Categories
Funding
- Public Health Service from the National Cancer Institute (NCI), National Institutes of Health [5U24CA076518]
- National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health [5U24CA076518]
- National Institute of Allergy and Infectious Diseases, National Institutes of Health [5U24CA076518]
- NHLBI [1U24HL138660]
- NCI [1U24HL138660]
- Health Resources and Services Administration [HHSH250201700006C]
- Office of Naval Research [N00014-17-1-2388, N00014-17-1-2850, N00014-18-1-2045]
- Adaptive Biotechnologies
- Astellas Pharma US
- Atara Biotherapeutics Inc.
- Be The Match Foundation
- Fred Hutchinson Cancer Research Center
- Gamida Cell Ltd
- Gilead Sciences Inc.
- HistoGenetics Inc.
- Immucor
- Janssen Scientific Affairs LLC
- Karius Inc.
- Karyopharm Therapeutics Inc.
- Medac GmbH
- Medical College of Wisconsin
- MesoScale Diagnostics Inc.
- Millennium
- Takeda Oncology Co.
- Mundipharma EDO
- National Marrow Donor Program
- Novartis Pharmaceuticals Corp.
- Patient-Centered Outcomes Research Institute
- PIRCHE AG
- Shire
- Spectrum Pharmaceuticals Inc.
- St Baldrick's Foundation
- Swedish Orphan Biovitrum Inc.
- University of Minnesota
- Amgen Inc.
- bluebird bio Inc.
- Bristol-Myers Squibb Oncology
- Celgene Corp.
- Chimerix Inc.
- CytoSen Therapeutics Inc.
- Incyte Corp.
- Jazz Pharmaceuticals Inc.
- Kite Pharma Inc.
- Mediware
- Merck Co. Inc.
- Mesoblast
- Miltenyi Biotec Inc.
- Pfizer Inc.
- Pharmacyclics LLC
- Sanofi Genzyme
- Seattle Genetics
- Takeda Oncology
Ask authors/readers for more resources
There are limited data on the effect of donor body mass index (BMI) on peripheral blood stem cell (PBSC) mobilization response to granulocyte colony-stimulating factor (G-CSF), especially in unrelated donors. Obesity has been associated with persistent leukocytosis, elevated circulating progenitor cells, and enhanced stem cell mobilization. Therefore, we hypothesized that adequate collection of CD34(+) cells may be achieved with lower doses (per kilogram of body weight) of G-CSF in donors with higher BMI compared with donors with lower BMI. Using the Center for International Blood and Marrow Transplant Research database, we evaluated the impact of donor BMI on G-CSF-mobilized PBSC yield in healthy unrelated donors. We examined 20 884 PBSC donations collected at National Marrow Donor Program centers between 2006 and 2016. We found significantly higher collection yields in obese and severely obese donors compared with normal and overweight donors. An increase in average daily G-CSF dose was associated with an increase in stem cell yield in donors with normal or overweight BMI. In contrast, an increase in average daily G-CSF dose beyond 780 mu g per day in obese and 900 mg per day in severely obese donors did not increase cell yield. Pain and toxicities were assessed at baseline, during G-CSF administration, and postcollection. Obesity was associated with higher levels of self-reported donation-related pain and toxicities in the pericollection and early postdonation recovery periods. This study suggests a maximum effective G-CSF dose for PBSC mobilization in obese and severely obese donors, beyond which higher doses of G-CSF add no increased yield.
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