Stem cell mobilisation with 16 μg/kg vs 10 μg/kg of G-CSF for allogeneic transplantation in healthy donors

We compared two doses of recombinant human granulocyte-stimulating factor (G-CSF) for stem cell mobilisation in 90 healthy donors for allogeneic stem cell transplantation in a retrospective analysis. Group I (n = 46) received 10 mug/kg G-CSF (filgrastim) given as 5 mug/kg twice daily, and group 11 (n = 44) received 16 mug/kg, given as 8 mug/kg twice daily with a 12-h interval. The groups were well-balanced for age and body-weight. G-CSF application was performed on an outpatient basis, and leukapheresis was started in all donors on day 5. The most frequent side-effects of G-CSF were grade I/II, bone pain, headache and fatigue in both groups, whereas grade III of bone pain, headache and fatigue occurred in the 2 X 8 mug/kg group only. One serious non-fatal event with non-traumatic spleen rupture occurred in the 2 X 5 mug/kg group. The CD34(+) cell count in the first apheresis of all donors was 5.1 X 10(6)/kg donor weight (range, 1.5-19.3). The CD34(+) cell harvest was higher in the 2 X 8 mug/kg group than in the 2 X 5 mug/kg group (7.1 X 10(6)/kg vs 4.9 x 10(6)/kg; P = 0.09). The target of collecting >5.0 X 10(6) CD34(+) cells/kg donor weight with one apheresis procedure was achieved in 45% of group I and in 61% of group 11, respectively. Administering G-CSF at a dosage of 8 mug/kg twice daily leads to a higher CD34(+) cell yield than a dosage of 2 X 5 mug/kg, but is associated with increased toxicity and higher cost.