Weighty choices: Selecting optimal G-CSF doses for stem cell mobilization to optimize yield
PublisherAmerican Society of Hematology
MetadataShow full item record
AbstractThere are limited data on the effect of donor body mass index (BMI) on peripheral blood stem cell (PBSC) mobilization response to granulocyte colony-stimulating factor (G-CSF), especially in unrelated donors. Obesity has been associated with persistent leukocytosis, elevated circulating progenitor cells, and enhanced stem cell mobilization. Therefore, we hypothesized that adequate collection of CD341 cells may be achieved with lower doses (per kilogram of body weight) of G-CSF in donors with higher BMI compared with donors with lower BMI. Using the Center for International Blood and Marrow Transplant Research database, we evaluated the impact of donor BMI on G-CSF-mobilized PBSC yield in healthy unrelated donors. We examined 20 884 PBSC donations collected at National Marrow Donor Program centers between 2006 and 2016. We found significantly higher collection yields in obese and severely obese donors compared with normal and overweight donors. An increase in average daily G-CSF dose was associated with an increase in stem cell yield in donors with normal or overweight BMI. In contrast, an increase in average daily G-CSF dose beyond 780 mg per day in obese and 900 mg per day in severely obese donors did not increase cell yield. Pain and toxicities were assessed at baseline, during G-CSF administration, and postcollection. Obesity was associated with higher levels of self-reported donation-related pain and toxicities in the pericollection and early postdonation recovery periods. This study suggests a maximum effective G-CSF dose for PBSC mobilization in obese and severely obese donors, beyond which higher doses of G-CSF add no increased yield.
SponsorsPatient-Centered Outcomes Research Institute, PCORI; National Heart, Lung, and Blood Institute, NHLBI; Gilead Sciences; University of Minnesota, UM; Swedish Orphan Biovitrum; National Institute of Allergy and Infectious Diseases, NIAID; Karyopharm Therapeutics; Spectrum Pharmaceuticals; HistoGenetics; Bristol-Myers Squibb, BMS; National Institutes of Health, NIH: 1U24HL138660, 00014-17-1-2388, 250201700006C, 00014-17-1-2850, 00014-18-1-2045; National Cancer Institute, NCI; Amgen; Office of Naval Research, ONR; Shire; National Heart, Lung, and Blood Institute, NHLBI;
body mass index procedure
Granulocyte Colony-Stimulating Factor
Hematopoietic Stem Cell Mobilization
Peripheral Blood Stem Cells
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85082202343&doi=10.1182%2fbloodadvances.2019000923&partnerID=40&md5=003c9101a6b3713c51ce458896051744; http://hdl.handle.net/10713/12484
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