Dose and Schedule Effect of G-GSF for Stem Cell Mobilization in Healthy Donors for Allogeneic Transplantation

Abstract
In the present review, we analyze the literature regarding the dose and schedule effects of granulocyte stimulating factor (G-CSF) for stem cell mobilization of healthy donors for allogeneic stem cell transplantation. There is now evidence for a dose and schedule dependency of G-CSF in mobilizing peripheral blood progenitor cells (PBSC) in healthy donors for allogeneic stem cell transplantation. In general, a dose between 10 and 16 µ g/kg split into two doses is recommended. Leukapheresis should be performed on day 4 or 5. A higher dose of G-CSF might be appropriate in donors with low CD34+ baseline cell count (<2000/ml) or if a high CD34+ cell number is required. However, a higher dose of G-CSF results in a higher acute toxicity like bone and muscle pain or headache. Severe adverse events like thromboembolic events, cerebrovascular incidents, anaphylactoid reactions and an atraumatic splenic rupture have been rarely reported. A prolonged follow-up of the donors is needed to rule out late toxicity of the donors.

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