ACCEPTANCE AND FEASIBILITY OF PERIPHERAL STEM-CELL MOBILIZATION COMPARED TO BONE-MARROW COLLECTION FROM HEALTHY UNRELATED DONORS

Allogeneic peripheral blood stem cell transplantation leads to an earl ier engraftment compared to BMT, The feasibility, acceptance and long- term side-effects of G-CSF mobilisation of PBSC in unrelated healthy d onors needs to be evaluated, Forty unrelated healthy donors received G -CSF in a dose of 10 mu g/kg bodyweight for 5 days and two aphereses w ere performed. The donors were monitored prospectively, The data were compared to bone marrow harvests from unrelated donors. Almost all ste m cell donors reported some side-effects due to Filgrastim application . Bone pain (32), headache (20), chest pain (two) and night sweats (on e) were complained of. By taking analgesics, the pain was relieved in most cases. No donor discontinued the filgrastim application. Bone pai n and headache resolved within 2-4 days after termination of Filgrasti m application. There was, as expected, a seven-fold increase in the nu mber of total WBCs. There were no significant changes of platelet coun ts during G-CSF application. After 4 weeks haemoglobin concentration a nd platelet counts showed no significant differences compared to basel ine values. The aphereses were mostly tolerated very well. Eighteen do nors reported paraesthesia, one donor developed dizziness, two complai ned of nausea and vomiting. There was a significant decrease in platel et count (242 before, 98 x 10(9)/l after aphereses), Autologous platel ets were transfused after the second aphereses in four donors. These d ata were compared to data from 245 unrelated bone marrow donors, who h ad on average, 14 days bone pain and tiredness after donation. The G-C SF mobilisation and apheresis of peripheral blood stem cells is an alt ernative to traditional bone marrow harvesting in unrelated healthy do nors. It is well tolerated and the duration of side-effects on average is shorter than after the surgical procedure. So far no long-term eff ects have been observed in the followup.