@article {71,
	title = {Clinical toxicity and laboratory effects of granulocyte-colony-stimulating factor (filgrastim) mobilization and blood stem cell apheresis from normal donors, and analysis of charges for the procedures.[Erratum appears in Transfusion 1997 Jan;37(1):109]},
	journal = {Transfusion},
	volume = {36},
	year = {1996},
	note = {HPC},
	pages = {590 - 5},
	abstract = {BACKGROUND: Apheresis of granulocyte-colony-stimulating factor (filgrastim)-mobilized blood stem cells from normal donors is now being used in place of a marrow harvest in transplantation. How the adverse effects of and charges for this procedure compare with those of the standard marrow harvest is not known. STUDY DESIGN AND METHODS: Forty consecutive normal subjects who received filgrastim 96 micrograms/kg) subcutaneously twice daily for 4 to 6 days in preparation for apheresis were monitored prospectively by clinical and laboratory evaluation. RESULTS: Sixty-two percent of the subjects required oral analgesics. None discontinued filgrastim prematurely. Bone pain (82\%), headache (70\%), fatigue (20\%), and nausea (10\%) were reported. Filgrastim caused a mean eightfold increase in neutrophil counts, a mean twofold increase in lymphocyte counts, a mean twofold rise in alkaline phosphatase and lactate dehydrogenase levels, and minor changes in serum potassium, magnesium, and uric acid. Adverse events and laboratory effects resolved within 7 days after apheresis. No apheresis stem cell donor required transfusion or hospitalization, and only one required an additional clinic visit after completion of apheresis. By comparison, a retrospective analysis of 33 normal marrow donors demonstrated that all received transfusion(s), 3 were hospitalized, 3 required additional clinic visits after the marrow harvest. The median total charges related to the two procedures were comparable (p = 0.43), although the charges were significantly lower for donors requiring only one apheresis procedure (p = 0.002). CONCLUSION: Filgrastim mobilization and apheresis of blood stem cells constitute a safe, well-tolerated, and comparable or less expensive alternative to the traditional marrow harvest.},
	keywords = {*Granulocyte Colony-Stimulating Factor / ae [Adverse Effects], *Hematopoietic Stem Cell Transplantation, *Leukapheresis / ae [Adverse Effects], *Tissue Donors, Adolescent, Adult, Alkaline Phosphatase / bl [Blood], Analgesics / tu [Therapeutic Use], Blood Transfusion, Autologous / ut [Utilization], Bone Marrow Transplantation / ec [Economics], Child, Cost-Benefit Analysis, Fatigue / ci [Chemically Induced], Female, Filgrastim, Follow-Up Studies, Granulocyte Colony-Stimulating Factor / pd [Pharmacology], Headache / ci [Chemically Induced], Hematopoietic Stem Cell Transplantation / ec [Economics], Hospital Costs, Humans, L-Lactate Dehydrogenase / bl [Blood], Leukapheresis / ec [Economics], Leukocyte Count / de [Drug Effects], Male, Middle Aged, Nausea / ci [Chemically Induced], Pain / ci [Chemically Induced], Pain / dt [Drug Therapy], Pain / et [Etiology], Prospective Studies, Recombinant Proteins / ae [Adverse Effects], Recombinant Proteins / pd [Pharmacology], Retrospective Studies, Safety, Tissue and Organ Procurement / ec [Economics], Tissue and Organ Procurement / mt [Methods], Uric Acid / bl [Blood]},
	author = {Anderlini,P. and Przepiorka,D. and Seong,D. and Miller,P. and Sundberg,J. and Lichtiger,B. and Norfleet,F. and Chan,K. W. and Champlin,R. and Korbling,M.}
}
