Single vs twice daily G-CSF dose for peripheral blood stem cells harvest in normal donors and children with non-malignant diseases

The optimal dose and schedule of G-CSF for mobilization of peripheral blood stem cells (PBSC) is not well defined. G-CSF mobilization was performed in a group of healthy donors and paediatric patients for autologous back-up b efore receiving allogeneic stem cell transplant. Seventeen consecutive subj ects who received G-CSF at 5 mu g/kg/dose twice daily (group A) were compar ed with a historical control group of 25 subjects who received a single dai ly dose of 10 mu g/kg/day G-CSF (group B). Double blood volume apheresis fo r PBSC collection was started on day 5, G-CSF was continued and apheresis r epeated until the targeted CD34(+) cell dose was achieved. Both groups were comparable for sex, age, body weight and reason for PBSC collection. Over two-thirds of the subjects in both groups were less than 16 years of age. T he G-CSF priming and apheresis were well tolerated. When the first day aphe resis products were analyzed, group A resulted in significantly higher yiel d of total nucleated cells (5.91 vs 3.92 x 10(8)/kg, P = 0.013), mononuclea r cells (5.73 vs 3.92 x 10(8)/kg, P = 0.017), CD34(+) cells (2.80 vs 1.69 x 10(6)/kg, P = 0.049) and colony-forming units (107 vs 54 x 10(4)/kg, P = 0 .010) as compared with group B. We conclude that the two dose schedule is m ore efficient in mobilizing PBSC in normal donors and children with non-mal ignant diseases. This approach may reduce the number of aphereses required and thus reduce the transplant cost.