TRANSFUSIONS OF GRANULOCYTE-COLONY-STIMULATING FACTOR-MOBILIZED GRANULOCYTE COMPONENTS TO ALLOGENEIC TRANSPLANT RECIPIENTS - ANALYSIS OF KINETICS AND FACTORS DETERMINING POSTTRANSFUSION NEUTROPHIL AND PLATELETCOUNTS

BACKGROUND: Granulocyte-colony-stimulating factor (G-CSF) is a safe an d effective agent for mobilization of neutrophils in normal donors, co nsistently resulting in cell yields per leukapheresis (LA) procedure t hat are superior to those with other agents. LA components also contai n platelets, whose clinical relevance is unknown. STUDY DESIGN AND MET HODS: This study describes the kinetics of and analyzes the factors de termining the ANC and platelet count increments seen with each of thre e transfusions of granulocytes collected from HLA-matched sibling dono rs receiving G-CSF (n = 10; maximum of 3 LA procedures/donor). The tra nsfusions were given to recipients (n = 10) on alternate days beginnin g Day 1 after allogeneic bone marrow transplant (BMT). RESULTS: Signif icant, sustained increments in the recipient ANCs were observed after the transfusion of G-CSF-mobilized LA components. The mean peak posttr ansfusion increments in the ANCs were 1195, 729, and 631 per mu L with transfusion of donor LA components on Days 1, 3, and 5, respectively. The length of time that the mean posttransfusion ANG was at or above the baseline (pretransfusion) value was 25 to 37 hours, depending on t he post-BMT day when the component was administered. No consistent rel ationship was observed between LA component granulocyte dose, baseline recipient ANC, or temperature elevation and posttransfusion ANC incre ments. Large numbers of platelets (mean, 2.55 x 10(11)) were present i n LA components, and this resulted in significant increments from base line in the mean platelet count 1 hour after LA component transfusions . Between Days 1 and 7, the duration of severe neutropenia was shorter and the percentage of patients requiring nondonor platelet transfusio ns was less in study patients who received LA component transfusions t han in a similar historical control group who did not. CONCLUSION: The transfusion of G-CSF-mobilized, HLA-matched LA components to allogene ic BMT recipients resulted in significant and sustained increments in the ANC and the platelet count. Within the range examined, a relations hip between neutrophil dose and an increment in the ANC was not demons trated.