Mobilization and collection of CD34(+) cells for autologous transplantation of peripheral blood hematopoietic progenitor cells in children: analysis of two different granulocyte-colony stimulating factor doses

Introduction: The use of peripheral hematopoietic progenitor cells (HPCs) is the cell choice in autologous transplantation. The classic dose of granulocyte-colony stimulating factor (G-CSF) for mobilization is a single daily dose of 10μg/kg of patient body weight. There is a theory that higher doses of granulocyte-colony stimulating factor applied twice daily could increase the number of CD34(+) cells collected in fewer leukapheresis procedures.

Objective: The aim of this study was to compare a fractionated dose of 15μg G-CSF/kg of body weight and the conventional dose of granulocyte-colony stimulating factor in respect to the number of leukapheresis procedures required to achieve a minimum collection of 3×10(6) CD34(+) cells/kg body weight.

Methods: Patients were divided into two groups: Group 10 - patients who received a single daily dose of 10μg G-CSF/kg body weight and Group 15 - patients who received a fractioned dose of 15μg G-CSF/kg body weight daily. The leukapheresis procedure was carried out in an automated cell separator. The autologous transplantation was carried out when a minimum number of 3×10(6) CD34(+) cells/kg body weight was achieved.

Results: Group 10 comprised 39 patients and Group 15 comprised 26 patients. A total of 146 apheresis procedures were performed: 110 (75.3%) for Group 10 and 36 (24.7%) for Group 15. For Group 10, a median of three (range: 1-7) leukapheresis procedures and a mean of 8.89×10(6) CD34(+) cells/kg body weight (±9.59) were collected whereas for Group 15 the corresponding values were one (range: 1-3) and 5.29×10(6) cells/kg body weight (±4.95). A statistically significant difference was found in relation to the number of apheresis procedures (p-value <0.0001).

Conclusions: To collect a minimum target of 3×10(6) CD34(+) cells/kg body weight, the administration of a fractionated dose of 15μg G-CSF/kg body weight significantly decreased the number of leukapheresis procedures performed.