Peripheral blood stem cell mobilization and apheresis: analysis of adverse events in 94 normal donors

TitlePeripheral blood stem cell mobilization and apheresis: analysis of adverse events in 94 normal donors
Publication TypeJournal Article
Year of Publication1999
AuthorsMurata M, Harada M, Kato S, Takahashi S, Ogawa H, Okamoto S, Tsuchiya S, Sakamaki H, Akiyama Y, Kodera Y
JournalBone Marrow Transplant
Pagination1065 - 71
Date PublishedNov
ISSN0268-3369 (Print) 0268-3369 (Linking)
Accession Number10578156
Keywords*Blood Donors, Adolescent, Adult, Blood Component Removal / *adverse effects, Child, Fatigue, Female, Granulocyte Colony-Stimulating Factor / *adverse effects, Headache, Hematopoietic Stem Cell Mobilization / *adverse effects, Humans, Leukocyte Count, Male, Middle Aged, Multivariate Analysis, Nausea, Neutropenia, Pain, Platelet Count, Sleep Initiation and Maintenance Disorders, Vomiting

Adverse events were analyzed in 94 normal donors who underwent PBSC harvest with G-CSF. The median dose of G-CSF was 9.7 microg/kg/day (range, 2.0-16.7), and the duration of administration was 4-6 days. Frequent symptoms were bone pain (71%), general fatigue (33%), headache (28%), insomnia (14%), anorexia (11%), nausea and/or vomiting (11%). One donor (1%) developed grade 3 toxicity bone pain (WHO criteria). WBC counts and ANC increased during G-CSF administration. After leukapheresis, three donors (3%) developed grade 3 toxicity neutropenia. Platelet counts decreased after leukapheresis. Three donors (3%) developed grade 3 thrombocytopenia. The means of both ALP and LDH increased approximately 1.9-fold compared with pretreatment levels. In one pediatric donor (1%), ALP was elevated to the grade 3 toxicity level. From multivariate analysis, the incidence of bone pain increased when G-CSF was given at a dose of 8.8 microg/kg/day or more, headaches were frequent in donors younger than 35 years, and the incidence of nausea and/or vomiting was high in female donors. The peak levels of WBC counts and ANC and post-treatment level of LDH increased in correspondence with the escalation of G-CSF dose. All adverse events normalized on follow-up evaluation. In conclusion, although PBSC harvest for normal donors is acceptable, care must be taken for all donors in terms of their sex and age as well as the G-CSF dose. We recommend less than 8.8 microg/kg/day as the G-CSF dose for PBSC mobilization in normal donors.

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