Older age but not donor health impairs allogeneic granulocyte colony-stimulating factor (G-CSF) peripheral blood stem cell mobilization

Biol Blood Marrow Transplant. 2009 Nov;15(11):1394-9. doi: 10.1016/j.bbmt.2009.07.005. Epub 2009 Sep 8.

Abstract

We evaluated stem cell mobilization in 195 consecutive sibling donors who underwent a uniform mobilization regimen of granulocyte colony-stimulating factor (G-CSF) at 10 microg/kg/day divided into twice daily dosing. On day 5, peripheral blood (PB) CD34 cells/microL were measured immediately prior to peripheral blood stem cell (PBSC) apheresis. Failed mobilization was defined as <20 CD34 cells/microL on day 5. The median age was 52 years and 73 (37%) were 55 years or greater. Comorbid conditions by the Charlson Comorbidity Index (CCI) occurred in 13%, but only 3% had Karnofsky performance status (PS) <100%. Eight (4%) failed mobilization, defined as <20 CD34 cells/microL on day 5. Older age was associated with fewer CD34 cells/microL (P=.002). In addition, 6/73 (8.2%) older donors failed mobilization compared to 2/122 (1.6%) younger donors (P=.054). Comorbidity, sex, race, and donor weight did not influence mobilization. Although low PS was very uncommon, it was associated with reduced mobilization (P=.021), but not mobilization failure. A small fraction of older donors mobilize poorly, and this is not explained by standard measures of comorbidity or PS.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors*
  • Aged
  • Blood Cell Count
  • Body Weight
  • Comorbidity
  • Female
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / pharmacology*
  • Health Status*
  • Hematopoietic Stem Cell Mobilization / methods
  • Hematopoietic Stem Cell Mobilization / statistics & numerical data*
  • Humans
  • Living Donors*
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation*
  • Recombinant Proteins
  • Siblings
  • Transplantation, Homologous
  • Young Adult

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim