Peripheral blood stem cell collection from G-CSF-stimulated unrelated donors for second transplant

Peripheral blood stem cells (PBSCs) collected following stimulation with cy tokines are commonly used for autologous haematopoietic transplants. Curren tly, PBSCs are being used for syngeneic or allogeneic transplants from matc hed or haploidentical donors, However, many issues are still unanswered reg arding the early or late side-effects cytokines have on recipients and on h ealthy donors. The aims of this paper were to evaluate the experience acqui red worldwide in this field, to define the acceptability of stem cell donat ion by G-CSF-stimulated apheresis from unrelated donors after the failure o f a first donation, and to assess side-effects of G-CSF on unrelated donors . The use of PBSCs has increased tremendously over the last few years and i n the near future PBSCs will probably become the most relevant source of st em cells. Studies conducted so far have definitely concluded that G-CSF is safe and well tolerated. Results observed in transplants utilizing marrow s tem cells compared with results obtained in transplants utilizing PBSCs hav e shown that patients undergoing this latter procedure recover earlier, req uire a lower number of transfusions and spend fewer days in hospital with a consequent decrease in costs. We concluded that a second transplant by G-C SF-stimulated apheresis from an unrelated donor is definitely acceptable an d we designed a prospective study to better define all controversial aspect s. Donors will be given 10 mu g/kg/day of G-CSF subcutaneously for 5 days. One or two PBSC collection procedures will be performed: the first on day 5 and the second, if necessary, on day 6. Donors will be surveyed and blood counts monitored in a standardized manner during the process.