HEMAPHERESIS: Collection of two consecutive neutrophil concentrates for transfusion from donors mobilized with glycosylated granulocyte-CSF plus dexamethasone

• Published in: Transfusion (Philadelphia, Pa.) Vol. 44; no. 5; pp. 750 - 757
• Main Authors: Heuft, H G, Goudeva, L, Schwella, N, Blasczyk, R
• Format: Journal Article
• Language: English
• Published: 01.05.2004
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2004.03283.x

BACKGROUND:The objective of this study was to establish a mobilization and apheresis regimen for collection of two consecutive polymorphonuclear neutrophil (PMN) concentrates from the same donor. STUDY DESIGN AND METHODS:In this prospective study, 111 healthy unrelated volunteers underwent either one (Group 1, n = 57) or two consecutive granulocyte apheresis procedure (Group 2, n = 54) using the a cell separator (Spectra). Both Group 1 and 2 donors were initially mobilized with glycosylated G-CSF 6.0 mu g per kg (range, 5.2-7.0 mu g-kg) subcutaneously plus oral dexa-methasone (DXM, 8 mg) and underwent granulocyte apheresis (GA-1) 16 hours (range, 13-18 hr) after initial G-CSF+DXM. Group 2 donors were remobilized with a second DXM dose of 8 mg (n = 13), 4 mg (n = 15), 1.5 mg (n = 13), or none (n = 13), and a second apheresis (GA-2) was run 40 hours (range, 37-42 hr) after G-CSF+DXM administration and 12 hours after remobilization with DXM alone. RESULTS:Based on equivalent median preapheresis WBC and PMN counts of around 35 x 10 super(9) WBCs per L and 33 x 10 super(9) PMNs per L after initial mobilization the GA-1 yields were 85 x 10 super(9) PMNs per U (range, 34-150) in Group 1 and 75 x 10 super(9) PMNs per U (range, 35-135) in Group 2 (p = 0.14, NS). In Group 2, median preapheresis values of 19.6 x 10 super(9) WBCs per L (range, 9.5-37.0) and 16.6 x 10 super(9) PMNs per L (range, 8.8-34.8) were measured after remobilization and GA-2 yields of 49 x 10 super(9) WBCs per U (range, 26-113) and 42 x 10 super(9) PMNs per U (range, 21-95) were obtained. Borderline statistical differences in the GA-2 yields were observed from the remobilized donors: 8 mg: 36 x 10 super(9) PMNs per U (range, 23-60); 4 mg: 47 x 10 super(9) PMNs per U (range, 21-56) (p less than or equal to 0.04); 1.5 mg: 45 x 10 super(9) PMNs per U (range, 23-79); placebo: 36 x 10 super(9) PMNs per U (range, 26-95) (p less than or equal to 0.04). CONCLUSION:Two consecutive neutrophil concentrates for transfusion can be obtained after single stimulation with Lenograstim+DXM. A second application of DXM alone is necessary, but of limited value.