1.
Long-Term Safety of Short-Term Administration of Filgrastim (rhG-CSF) and Leukophresis Procedure in Healthy Children: Application of Peripheral Blood Stem Cell Collection in Pediatric Donors
Behfar, M., Faghihi-Kashani, S., Hosseini, A. S., Ghavamzadeh, A., Hamidieh, A. A.
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2018;24(4):866-870
Abstract
Administration of filgrastim (recombinant human granulocyte colony-stimulating factor [rhG-CSF]) (Neupogen) in healthy donors to mobilize hematopoietic stem cells (HSCs) is a widespread practice in adults. Application of peripheral blood stem cell (PBSC) collection in normal pediatric donors is scarce due to ethical issues. Hence, there are insufficient data on the long-term impact of PBSC procedure in healthy children. This retrospective study aimed to evaluate the early and late adverse effects of PBSC donation in pediatric donors. Bone marrow and PBSC procedures and known adverse events of each technique were completely explained to parents and when applicable to children and written informed consent was obtained. rhG-CSF was administered for 4 days. HSCs were collected on the fifth day through continuous-flow apheresis and donors were followed for 30 days. Manual chart review was performed to collect short-term complications. Donors' health status was assessed via a questionnaire. A total of 145 healthy pediatric donors with a median age of 10 years at the time of donation (2 to 15 years) were followed for a median of 4.8 years (range, 1.2 to 14.2 years). The most frequent symptoms of rhG-CSF administration were fatigue (5%) and headache (3%). Thirty-five (24%) donors experienced hypocalcaemia during apheresis procedure that quickly responded to treatment. Two pregnancies occurred after rhG-CSF administration that resulted in normal births. We did not encounter any serious adverse events, including neoplastic disorders and death in this study. rhG-CSF and leukophresis procedure were well-tolerated in this study and all children completed the donation process without interruption or reduction of rhG-CSF dosage. Our results suggest that rhG-CSF is a safe drug in healthy children for the purpose of HSC mobilization.
2.
The effects of lower CD34 yields after lowe dose G-CSF induction on long-term autologous stem cell transplantation outcome: A single center study
Vaezi, M., Shakouri, M., Souri, M., Setaredan, M. A., Mossavi, S. A., Mohammadi, S., Alimoghaddam, K., Ghavamzadeh, A.
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2018
Abstract
Peripheral blood stem cell transplantation (PBSCT) is an effective treatment for hematological malignancies. Mobilization of peripheral blood stem cells performs in different ways among transplantation centers. Since the Effects of lower CD34+ cells dose after low dose G-CSF induction on autologous stem cell transplantation outcomes are not studied much, so this study was performed for this purpose. 735 autologous stem cell transplanted patients with diagnoses of multiple myeloma (n=330), Hodgkin lymphoma (n=200), non-Hodgkin lymphoma (n=129), acute myeloid leukemia (n=54) and solid tumors (n=22) were retrospectively evaluated. G-CSF was administered at the dose of 5mug/kg/day during mobilization and all patients except acute myeloid leukemia received 10mug/kg/day on the last day. Peripheral blood stem cells were harvested in one session for all patients. The amount of injected CD34+ cells/kg for patients were divided and studied in four groups: <0.5x10(6) (n=36), 0.5-1.0x10(6), (n=132), 1.0-2.0x10(6) (n=226) and >2.0x10(6) (n=305). The median time of follow up was 26.9 months. The amount of CD34+ cells dose were a significant predictor of platelet engraftment, but overall survival, relapse-free survival and also relapse rate was not associated with cells yield. More platelet transfusion (P=0.003) and antibiotics prescription (P=0.001) in transplanted patients with lower CD34 cells dose should be balanced with risks of higher G-CSF doses administration and also its side effects. Our results declare that lower CD34 yields after lowe dose G-CSF induction are probably not a troublesome issue affecting transplantation outcomes.
3.
How do anxiety affect CD34 and CD3 cells in allogeneic peripheral blood stem cell transplantation?
Larijani, T. T., Mohammadi, S., Kasaeian, A., Malek Mohammadi, A., Mostafaei, S., Alimoghaddam, K., Ghavamzadeh, A.
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2018
Abstract
Allogeneic peripheral blood stem cells (PBHSCs) transplantation using apheresis is a curative method for malignant and non-malignant hematologic diseases. The aim of this study was to assess the possible effects of anxiety as well as other variables on PBHSCs apheresis success. In this cross-sectional study, different demographic and clinical data such as granulocyte-colony stimulating factor (G-CSF) dosage, CD 34(+) cells count (before apheresis), CD 34(+), CD3(+) cells count in apheresis product and also complete blood count were assessed. Furthermore, for evaluation of anxiety level in donors, the Beck's anxiety inventory (BAI) was administered. In this study, 111 donors were randomly enrolled after meeting inclusion and exclusion criteria. Results of BAI showed the mean score of 22.85+/-15.43 (mild to moderate anxiety) for the participants. According to the bootstrapped quantile regression analysis, a statistically significant linear association was found between CD34(+) cell count and BAI score (P-value<0.001) after adjusting for confounding variables. Moreover, the BAI score had a statistically significant effect on CD3(+) cells count (P-value=0.021) after adjusting for confounding variables. Taken together, results showed that anxiety affects both CD34(+) and CD3(+) cells count. Thus, the authors suggest that anxiety levels would be evaluated as well as other variables in donors in order to run a proper intervention by professionals.