1. Donor-intrinsic variables determine mobilization efficiency: analyses from a cohort of sixty twice-mobilized stem cell donors.
- Author
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Kim-Wanner, Soo-Zin, Lee, Seo-Youn, Seifried, Erhard, and Bonig, Halvard
- Subjects
STEM cell donors ,STEM cell transplantation ,COHORT analysis ,STEM cells ,LEUKAPHERESIS ,RESEARCH ,GRANULOCYTE-colony stimulating factor ,RESEARCH methodology ,MEDICAL cooperation ,EVALUATION research ,BIOTHERAPY ,COMPARATIVE studies ,HEMAPHERESIS ,HEMATOPOIETIC stem cell transplantation ,ANTIGENS - Abstract
Background: Healthy volunteer registry donors have become the backbone of stem cell transplantation programs. While most registrants will never become actual donors, a small minority are called upon twice, most commonly for the same patient because of poor graft function. Anecdotal evidence provides no hard reasons to disallow second-time mobilized apheresis, but few centers have treated enough two-time donors for definitive conclusions. Moreover, for reasons unknown, the efficiency of G-CSF varies greatly between donations.Methods: Comparison of outcomes of first vs. second donations can formally confirm G-CSF responsiveness as intrinsically, likely genetically, determined. In our database, we identified 60 donors (1.3%) who received two cycles of G-CSF 24 days to 4 years apart and systematically compared mobilization outcomes.Results: First and second mobilization and collection proceeded without severe or unusual adverse effects. First-time mobilization efficiency was highly predictive of second-time mobilization. Neither mobilization efficiency nor time lag between donations affected the similarity of first- and second-time mobilization outcomes.Conclusions: With the caveat that only donors with an unremarkable first donation were cleared for a second, our data indicate that a second donation is feasible, equally tolerable as a first donation, and efficient. Moreover, the data strongly support the notion of donor-intrinsic variables dictating mobilization response and argue against relevant damage to the stem cell compartment during mobilization with rhG-CSF. [ABSTRACT FROM AUTHOR]- Published
- 2020
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