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Comparison between peripheral blood progenitor cell collection on the 4th or 5th day of granulocyte colony-stimulating factor treatment in allogeneic stem cell donors: implications for hematopoietic progenitor cell apheresis guidelines

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Publication Date: 2022-08-09

Abstract

INTRODUCTION
The collection of hematopoietic progenitor cells by apheresis, designated hematopoietic progenitor cells apheresis (HPC-A), is the most frequently used source of CD34+ cells for hematopoietic stem cell transplantation (HSCT)1. The biggest advantage of HPC-A, compared to bone marrow harvest, is represented by the large number of CD34+ cells that can be obtained, which leads to a more rapid engraftment in the allogeneic setting2. However, in order to reach the optimal target CD34+ cell dose (>4×106/kg recipient bodyweight)3 t o p erform a t ransplant, t he d onor m ust receive g ranulocyte colony-stimulating factor (G-CSF) to mobilise progenitor cells from the bone marrow4. National and international guidelines recommend the first apheresis on the 4th or 5th day of G-CSF treatment (10 μg/kg, divided into two daily injections) when the CD34+cell concentration in peripheral blood reaches its maximum4-6. Unfortunately, this treatment is associated with side effects such as bone and muscle pain7, nausea7, headaches8, and
(more rarely) splenic rupture9, myocardial infarction and thrombotic events, which appear to be directly dependent on the administered dose of G-CSF10.

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Authors

Cecilia Passeri - Department of Oncology and Hematology, Ospedale Civile "Santo Spirito", ASL Pescara, Pescara, Italy

Ornella Iuliani - Department of Oncology and Hematology, Ospedale Civile "Santo Spirito", ASL Pescara, Pescara, Italy

Mauro Di Ianni - Department of Oncology and Hematology, Ospedale Civile "Santo Spirito", ASL Pescara, Pescara, Italy; Department of Medicine and Sciences of Aging, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy

Carlo Sorrentino - Department of Medicine and Sciences of Aging, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy

Raffaella Giancola - Department of Oncology and Hematology, Ospedale Civile "Santo Spirito", ASL Pescara, Pescara, Italy

Luciano Abbruzzese - Servizio di Immunoematologia e Medicina Trasfusionale, Azienda Ospedaliera "Card. G. Panico", Tricase (LE), Italy

Franco M. Dallavalle - Divison of Transfusion Medicine, A.O. SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy

Salvatore Gattillo - Servizio di Immunoematologia e Medicina Trasfusionale, IRCCS San Raffaele Scientific Institute, Milan, Italy

Maria T. Mariano - Servizio di Immunoematologia e Medicina Trasfusionale, AUSL di Piacenza, Piacenza, Italy

Massimo Martino - Centro Unico Regionale Trapianti Cellule Staminali e Terapie Cellulari (CTMO), Grande Ospedale Metropolitano "Bianchi Melacrino Morelli", Reggio, Calabria, Italy

Angelo Ostuni - Unità Operativa di Medicina Trasfusionale, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, University of Bari "Aldo Moro", Bari, Italy

Chiara Savignano - Dipartimento di Medicina Trasfusionale, General and University Hospital, Udine, Italy

Luca Santoleri - Servizio di Immunoematologia e Medicina Trasfusionale, IRCCS San Raffaele Scientific Institute, Milan, Italy

Tiziana Tison - Dipartimento Interaziendale di Medicina Trasfusionale, University Hospital of Padua, Padua, Italy

Michele Vacca - Unità Operativa Complessa di Medicina Trasfusionale e Terapia Cellulare, Fondazione Policlinico Campus Biomedico, Rome, Italy

Patrizia Accorsi - Department of Oncology and Hematology, Ospedale Civile "Santo Spirito", ASL Pescara, Pescara, Italy

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