Administration of erythopoietin and granulocyte colony-stimulating factor in donor/recipient pairs to collect peripheral blood progenitor cells (PBPC) and red blood cell units for use in the recipient after allogeneic PBPC transplantation

• Published in: Haematologica (Roma) Vol. 86; no. 11; pp. 1209 - 1218
• Main Authors: Sautois, B, Baudoux, E, Salmon, JP, Michaux, S, Schaaf-Lafontaine, N, Pereira, M, Paulus, JM, Fillet, G, Beguin, Y
• Format: Journal Article Web Resource
• Language: English
• Published: Pavia Haematologica 01.11.2001; Ferrata Storti Foundation
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Donors; Bone marrow, stem cells transplantation. Graft versus host reaction; Cytapheresis - methods; Erythrocyte Transfusion; Erythropoietin - administration & dosage; Erythropoietin, Recombinant/administration & dosage; Feasibility Studies; Female; Graft Survival; Granulocyte Colony-Stimulating Factor - administration & dosage; Hematology; Hematopoietic Stem Cell Mobilization - methods; Hematopoietic Stem Cell Transplantation; Human health sciences; Humans; Hématologie; Leukapheresis; Male; Medical sciences; Middle Aged; Prospective Studies; Recombinant Proteins; Sciences de la santé humaine; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous; Human; Intravenous administration; Erythropoietin; Hematology; Stem cell; Cytokine; Hematopoietic cell; Red blood cell; Homograft; Receiver; Iron; Glycoprotein hormone; Blood; Granulocyte colony stimulating factor; Polypeptide; Graft; Pretreatment; Technique; Blood donor; Growth factor
• ISSN: 0390-6078; 1592-8721; 1592-8721

Department of Medicine, Division of Haematology, University of Liege, Liege, Belgium. BACKGROUND AND OBJECTIVES: It may be useful to reduce the exposure of transplant recipients to homologous blood. This may be achieved by procuring donor-derived red blood cell (RBC) units, collecting more peripheral blood progenitor cells (PBPC) with a combination of granulocyte colony-stimulating factor (G-CSF) + recombinant human erythropoietin (rHuEpo) and by administering rHuEpo post-transplantation. DESIGN AND METHODS: Eight ABO-compatible donors were treated with rHuEpo and intravenous iron to collect 12 RBC units for use in their recipients. PBPC were collected after mobilization with rHuEpo and G-CSF in the same donors. The recipients received G-CSF and rHuEpo post-transplantation. A control group of 10 donor/recipient pairs received G-CSF alone for PBPC mobilization and after the transplantation. RESULTS: Eighty-six out of 91 planned RBC units were collected in the donors without significant decrease in hematocrit because of a 4-fold increase in RBC production despite functional iron deficiency. After 2 leukaphereses, the cumulative yields of NC and CFU-GM were lower in the study group while those of BFU-E, CFU-Mix and CD34+ cells were similar. However, erythroid recovery was significantly accelerated in the study group. INTERPRETATION AND CONCLUSIONS: Collection of 12 RBC units within 6 weeks is feasible with rHuEpo and intravenous iron; this strategy allows a dramatic reduction in recipient exposure to homologous blood; rHuEpo has no synergistic effect with G-CSF for mobilization of PBPC in normal donors and may even be deleterious; and rHuEpo in the recipient may enhance erythroid engraftment.