Analysis of stem cell apheresis products using intermediate-dose filgrastim plus large volume apheresis for allogeneic transplantation

Previously, a dose-dependent influence of recombinant human granulocyte col ony-stimulating factor (rhG-CSF) on CD34+ mobilization was demonstrated. In this single-center prospective analysis, 52 healthy donors were investigat ed to determine the efficacy of intermediate-dose rhG-CSF 2x8 mug/kg donor body weight (bw) and intermediate large volume apheresis (LVA, median 12 1) to mobilize peripheral blood progenitor cells (PBPC) for allogeneic transp lantation. The median number of CD34+ cells in apheresis products was 0.45% and 2.2x10(6)/kg recipient bw per single apheresis. A total of 5.4x10(6)/k g CD34+ cells were collected with two (range: one to three) LVA. In the ana lysis of donor subgroups, higher peripheral blood (PB) and apheresis result s were obtained in male vs female donors; however, donor weight significant ly differed in both groups. Heavier donors displayed higher PB and apheresi s CD34+ counts; however, when CD34+ cells/kg were adjusted to a constant bw , similar harvest results were calculated in males and females, demonstrati ng that gender per se does not, whereas bw does affect apheresis results. Y ounger donors had significantly higher PB CD34+ counts, higher CD34+ number s per single apheresis, increased CFU, more T, B, and CD61+, comparable NK, and less CD14+ cells. A correlation analysis of donor age and apheresis re sults displayed an age-related decline of 0.46x10(6)/kg CD34 cells per deca de of donor aging. Cell subsets in apheresis products were CD14 (49%), CD3 (22%), CD4 (13%), CD8 (7%), CD61 (20%), CD19 (5%), and CD16/56+ (3%) cells, with increasing CD14+ cells and decreasing CD3, CD4, CD8, CD61, CD19, and CD16/56+ cells on subsequent days of apheresis. Compared to our previous an alysis using high- (2x12 mug) and low-dose (1x10 mug) rhG-CSF for allogenei c PBPC mobilization, the intermediate-dose showed a similar CD34+ mobilizat ion potential to 1x10 mug rhG-CSF; however, with use of LVA, two instead of three (p <0.05) aphereses were sufficient to mobilize greater than or equa l to 4x10(6)/kg bw CD34+ cells in most donors. Taken together, our results demonstrate that intermediate-dose rhG-CSF sufficiently mobilizes greater t han or equal to 4x10(6)/kg bw CD34+ cells with use of LVA and that especial ly younger donors display increased CD34+ cell numbers.