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Li L, Yin J, Li Y, Wang C, Mao X, Wei J, Cao Y, Wang N, Lin L, Xu J, Zhang Y. Allogeneic Hematopoietic Stem Cell Transplantation Mobilized With Pegylated Granulocyte Colony-Stimulating Factor Ameliorates Severe Acute Graft-Versus-Host Disease Through Enrichment of Monocytic Myeloid-Derived Suppressor Cells in the Graft: A Real World Experience. Front Immunol 2021; 12:621935. [PMID: 33912154 PMCID: PMC8072473 DOI: 10.3389/fimmu.2021.621935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/11/2021] [Indexed: 11/24/2022] Open
Abstract
We compared the effectiveness and safety of pegylated granulocyte colony-stimulating factor (peg-G-CSF) vs. non-peg-G-CSF for hematopoietic stem cell mobilization in allogeneic hematopoietic stem cell transplantation in a real-world setting. We included 136 consecutive healthy donors treated with non–peg-G-CSF (n = 53) or peg-G-CSF (n = 83), and 125 consecutive recipients (n = 42 and 83, respectively) in this study. All harvesting was completed successfully. No significant difference in leukapheresis number and adverse events frequency was observed, nor were there severe adverse events leading to discontinuation of mobilization. The leukapheresis products mobilized by peg-G-CSF had higher total nucleated cells (p < 0.001), monocytic myeloid-derived suppressor cells (p < 0.001), granulocytic myeloid-derived suppressor cells (p = 0.004) and B cells (p = 0.019). CD34+ cells and other lymphocyte subsets (T cells, regulatory T cells, natural killer [NK] cells, etc.) were similar in both apheresis products. Patients who received grafts mobilized by peg-G-CSF exhibited a lower incidence of grade III-IV acute graft-versus-host disease (p = 0.001). The 1-year cumulative incidence of chronic graft-versus-host disease and relapse, 1-year probability of graft-versus-host disease-free relapse-free survival, and overall survival did not differ significantly between subgroups. Our results suggest that collecting allogeneic stem cells after the administration of peg-G-CSF is feasible and safe. Peg-G-CSF mobilized grafts may reduce severe acute graft-versus-host disease compared with non-peg-G-CSF mobilized grafts after allogeneic stem cell transplantation. The beneficial effects of a peg-G-CSF graft might be mediated by increased numbers of monocytic myeloid-derived suppressor cells.
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Affiliation(s)
- Lin Li
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin Yin
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Li
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Wang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xia Mao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Wei
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Cao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Na Wang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Lin
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhuan Xu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yicheng Zhang
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Alvarez P, Carrillo E, Vélez C, Hita-Contreras F, Martínez-Amat A, Rodríguez-Serrano F, Boulaiz H, Ortiz R, Melguizo C, Prados J, Aránega A. Regulatory systems in bone marrow for hematopoietic stem/progenitor cells mobilization and homing. BIOMED RESEARCH INTERNATIONAL 2013; 2013:312656. [PMID: 23844360 PMCID: PMC3703413 DOI: 10.1155/2013/312656] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 04/22/2013] [Accepted: 05/24/2013] [Indexed: 12/14/2022]
Abstract
Regulation of hematopoietic stem cell release, migration, and homing from the bone marrow (BM) and of the mobilization pathway involves a complex interaction among adhesion molecules, cytokines, proteolytic enzymes, stromal cells, and hematopoietic cells. The identification of new mechanisms that regulate the trafficking of hematopoietic stem/progenitor cells (HSPCs) cells has important implications, not only for hematopoietic transplantation but also for cell therapies in regenerative medicine for patients with acute myocardial infarction, spinal cord injury, and stroke, among others. This paper reviews the regulation mechanisms underlying the homing and mobilization of BM hematopoietic stem/progenitor cells, investigating the following issues: (a) the role of different factors, such as stromal cell derived factor-1 (SDF-1), granulocyte colony-stimulating factor (G-CSF), and vascular cell adhesion molecule-1 (VCAM-1), among other ligands; (b) the stem cell count in peripheral blood and BM and influential factors; (c) the therapeutic utilization of this phenomenon in lesions in different tissues, examining the agents involved in HSPCs mobilization, such as the different forms of G-CSF, plerixafor, and natalizumab; and (d) the effects of this mobilization on BM-derived stem/progenitor cells in clinical trials of patients with different diseases.
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Affiliation(s)
- P. Alvarez
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - E. Carrillo
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - C. Vélez
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - F. Hita-Contreras
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Health Science, University of Jaén, 23071 Jaén, Spain
| | - A. Martínez-Amat
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Health Science, University of Jaén, 23071 Jaén, Spain
| | - F. Rodríguez-Serrano
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - H. Boulaiz
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - R. Ortiz
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Health Science, University of Jaén, 23071 Jaén, Spain
| | - C. Melguizo
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - J. Prados
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - A. Aránega
- Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18071 Granada, Spain
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3
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Abstract
The use of mobilized peripheral blood stem cells (PBSCs) has largely replaced the use of bone marrow as a source of stem cells for both allogeneic and autologous stem cell transplantation. G-CSF with or without chemotherapy is the most commonly used regimen for stem cell mobilization. Some donors or patients, especially the heavily pretreated patients, fail to mobilize the targeted number of stem cells with this regimen. A better understanding of the mechanisms involved in hematopoietic stem cell (HSC) trafficking could lead to the development of newer mobilizing agents and therapeutic approaches. This review will cover the current methods for stem cell mobilization and recent developments in the understanding of the biology of stem cells and the bone marrow microenvironment.
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Affiliation(s)
- Ibraheem H Motabi
- Siteman Cancer Center, Washington University School of Medicine, 660 S Euclid Ave, St. Louis, MO 63110, USA.
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Jimenez A, Fung HC, Christopherson KW. Cellular therapies supplement: strategies for improving transplant efficiency in the context of cellular therapeutics. Transfusion 2012; 51 Suppl 4:125S-137S. [PMID: 22074623 DOI: 10.1111/j.1537-2995.2011.03375.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The field of hematopoietic stem cell transplantation (HSCT) has overcome many obstacles that have led to our current clinical ability to utilize cells collected from marrow, mobilized peripheral blood, or umbilical cord blood for the treatment of malignant and nonmalignant hematologic diseases. It is in this context that it becomes evident that future progress will lie in our development of an understanding of the biology by which the process of HSCT is regulated. By understanding the cellular components and the mechanisms by which HSCT is either enhanced or suppressed it will then be possible to design therapeutic strategies to improve rates of engraftment that will have a positive impact on immune reconstitution post-HSCT. In this review we focus primarily on allogeneic hematopoietic stem cell transplantation (allo-HSCT), the current challenges associated with allo-HSCT, and some developing strategies to improve engraftment in this setting.
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Affiliation(s)
- Antonio Jimenez
- Section of Hematology & Section of Bone Marrow Transplant and Cell Therapy, Division of Hematology/Oncology/Cell Therapy, Rush University Medical Center, Chicago, Illinois 60612, USA
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Brauninger S, Bialleck H, Thorausch K, Felt T, Seifried E, Bonig H. Allogeneic donor peripheral blood “stem cell” apheresis: prospective comparison of two apheresis systems. Transfusion 2011; 52:1137-45. [DOI: 10.1111/j.1537-2995.2011.03414.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pierelli L, Perseghin P, Marchetti M, Accorsi P, Fanin R, Messina C, Olivieri A, Risso M, Salvaneschi L, Bosi A. Best practice for peripheral blood progenitor cell mobilization and collection in adults and children: results of a Società Italiana Di Emaferesi e Manipolazione Cellulare (SIDEM) and Gruppo Italiano Trapianto Midollo Osseo (GITMO) consensus process. Transfusion 2011; 52:893-905. [DOI: 10.1111/j.1537-2995.2011.03385.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Alasheev AM, Belkin AA, Leiderman IN, Ivanov RA, Isakova TM. Granulocyte-colony-stimulating Factor for Acute Ischemic Stroke: A Randomized Controlled Trial (STEMTHER). Transl Stroke Res 2011; 2:358-65. [PMID: 24323654 DOI: 10.1007/s12975-011-0091-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 07/10/2011] [Accepted: 07/11/2011] [Indexed: 11/28/2022]
Abstract
Granulocyte-colony-stimulating factor (G-CSF) functions both as a neuroprotectant and a stimulator of autologous bone marrow stem cell release. Therefore, administration of G-CSF should improve the outcome of stroke. Here, we examine the safety of using G-CSF to treat acute ischemic stroke using a randomized controlled trial involving 20 adult patients presenting with ischemia in the carotid region within 48 h of onset. The experimental group (n = 10) received subcutaneous G-CSF injections (10 mg kg(-1) day(-1)) in addition to conventional therapy for 5 days. The primary outcome was motor function as measured by the modified Rankin Scale 180 days post-stroke. Safety was evaluated according to the frequency of hemorrhagic transformation of infarctions and serious adverse events. Only six patients in the experimental group completed full course of treatment, while four patients (three in the control and one in the experimental group) were lost to follow-up. We found the experimental and control groups did not differ significantly in either neurological impairment or degree of disability/dependence at 180 days post-stroke. We conclude that while adding G-CSF (10 mg kg(-1) day(-1)) to acute ischemic stroke therapy for 5 days is safe, its efficacy remains unproven.
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Affiliation(s)
- Andrey Marisovich Alasheev
- Clinical Institute of the Brain, Ural Department, Russian Academy of Medical Sciences, Yasnaya str. 38, 620102, Yekaterinburg, Russia
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8
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Brauninger S, Bialleck H, Thorausch K, Seifried E, Bonig H. Mobilized allogeneic peripheral stem/progenitor cell apheresis with Spectra Optia v.5·0, a novel, automatic interface-controlled apheresis system: results from the first feasibility trial. Vox Sang 2011; 101:237-46. [DOI: 10.1111/j.1423-0410.2011.01484.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Hematopoietic colony-stimulating factors: new players in tumor-nerve interactions. J Mol Med (Berl) 2010; 89:321-9. [PMID: 21079906 PMCID: PMC3055988 DOI: 10.1007/s00109-010-0697-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 10/02/2010] [Accepted: 10/28/2010] [Indexed: 12/30/2022]
Abstract
A variety of cancers are accompanied by debilitating pain, which constitutes the primary reason for poor quality of life in cancer patients. There is an urgent demand for the development of specific mechanism-based therapies against cancer pain. Recently, important advances have been made in mechanisms contributing to cancer pain. A notable finding was that the tumor-derived hematopoietic growth factors, granulocyte- and granulocyte-macrophage-colony-stimulating factors (G-CSF/GM-CSF), subserve important functions in the generation of pain hypersensitivity in tumor-affected regions. In this context, their receptors were unexpectedly found on pain-sensing nerves and were observed to be functionally linked to nociceptive sensitization and tumor-induced pain. Here, we review evidence supporting a role for G-/GM-CSF in sensitization of pain-sensing nerves, the underlying signaling pathways and the cross-talk with other pronociceptive cytokines, peptides and modulators derived from immune cells, osteoclasts and tumor cells. These findings hold implications in the therapy of pain in disease states, such as cancer and rheumatoid arthritis.
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Chen SH, Lu CJ, Wen SH, Zheng YJ, Yang SH, Su YC, Li DK. Is a boosting dose of granulocyte-colony-stimulating factor necessary for healthy PBSC donors undergoing secondary apheresis? An institute's experience. Transfus Apher Sci 2009; 40:87-90. [PMID: 19233726 DOI: 10.1016/j.transci.2009.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Successful allogeneic PBSC transplantation depends upon the infusion of an adequate number of CD34+ cells to patients. Granulocyte-colony-stimulating factors (G-CSF) mobilized PBSC were harvested on 5th day after stimulation from donors. When the CD34+ cell target yield was not achieved; secondary apheresis was performed the following day. Before September 2006, 67 donors (Group A) received five doses of G-CSF. After September 2006, a sixth dose of G-CSF was administered to 35 donors (Group B) to improve CD34+ yield. The mean CD34+-cell concentration of the second PBSC harvest was significantly higher in Group B (1,087 x 10(6)/l vs. 767 x 10(6)/l; P = 0.031).
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Affiliation(s)
- Shu-Huey Chen
- Department of Paediatrics, Hualien Tzu-Chi Hospital, Hualien 970, Taiwan.
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11
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Zhang C, Chen X, Zhang X, Gao L, Kong P, Wang Q, Peng X, Liu H. Mobilization of peripheral blood stem cells for autologous transplantation patients with hematological malignancies: Influence of disease, mobilization method, age and sex. Transfus Apher Sci 2008; 39:21-8. [PMID: 18599353 DOI: 10.1016/j.transci.2008.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Autologous peripheral blood stem cells transplantation (Auto-PBSCT) is a therapeutic option which can be used in various hematological neoplastic disorders; and it can prolong disease-free survival and total survival. Many factors could influence the mobilization of peripheral blood stem cells for patients of Auto-PBSCT. In this study, we investigated the variables influencing the mobilization of peripheral blood stem cells in 240 patients with hematological malignancies who had undergone Auto-PBSCT between 2001 and March 2007 in our center, retrospectively. Patients with acute myelogenous leukemia had the most collected mononuclear cells (MNCs) and patients with acute lymphoblastic leukemia had the most collected CD34(+) cells than did other patients. However, patients with multiple myeloma had the least collected MNCs and CD34(+) cells. Patients mobilized with chemotherapy with granulocyte colony stimulating factor (G-CSF) plus recombinant human interleukin-11(rhIL-11) had the most collected MNCs and CD34(+) cells. The difference is statistical signification between chemotherapy with G-CSF and chemotherapy with G-CSF plus rhIL-11 for collected MNCs (P<0.05). Adults had the most collected MNCs and CD34(+) cells and the difference is statistical signification between children/adolescent and older, children/adolescent and adult for CD34(+) cells (P<0.05). Male patients had the more collected MNCs and CD34(+) cells and the difference is statistical signification for CD34(+) cells (P<0.05). The adverse events were not serious during mobilization. In conclusion, many factors could influence the mobilization of peripheral blood stem cells, and our findings emphasize the need to optimize harvesting technique to enhance safety and minimize morbidity and costs of this valuable procedure.
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Affiliation(s)
- Cheng Zhang
- Department of Hematology, Xinqiao Hospital, Third Military Medical University Chongqing, People's Republic of China.
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12
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13
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Kroschinsky F, Hölig K, Ehninger G. The role of pegfilgrastim in mobilization of hematopoietic stem cells. Transfus Apher Sci 2008; 38:237-44. [DOI: 10.1016/j.transci.2008.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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14
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Jang G, Ko OB, Kim S, Lee DH, Huh J, Suh C. Prospective randomized comparative observation of single- versus split-dose lenograstim to enhance engraftment after autologous stem cell transplantation in patients with multiple myeloma or non-Hodgkin's lymphoma. Transfusion 2008; 48:640-6. [DOI: 10.1111/j.1537-2995.2007.01588.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Mobilization of peripheral blood stem cells. Transfus Apher Sci 2007; 37:179-85. [DOI: 10.1016/j.transci.2007.08.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Accepted: 08/02/2007] [Indexed: 11/17/2022]
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Jawad M, Giotopoulos G, Cole C, Plumb M. Target cell frequency is a genetically determined risk factor in radiation leukaemogenesis. Br J Radiol 2007; 80 Spec No 1:S56-62. [PMID: 17704327 DOI: 10.1259/bjr/99530445] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Whole body exposure to ionizing radiation increases the risk of radiation-induced acute myeloid leukaemia (r-AML). r-AML is the result of the accumulation of mutations in a single haemopoietic stem cell, so risk is therefore a function of the number of mutations required to transform the stem cell and the mutation rate. There is a genetic component to the risk of AML within the general population, and low penetrance variant alleles encoding DNA repair enzymes have been genetically implicated in therapy-related AML susceptibility. However, what is largely ignored is that target cell number, which defines the number of genomes at risk from DNA damaging agents, is also part of the equation that defines risk. We will review the evidence from genetic studies of inbred mouse models that target cell frequency is a risk factor in radiation leukaemogenesis. Inbred mouse strains that differ in their susceptibility to radiation-induced r-AML and thymic lymphoma (r-TL), spontaneous TL and pristane-induced plasmacytoma (PCT) have been exploited to identify susceptibility loci. The target cell in AML is the haemopoietic stem cell, whereas TLs and PCT arise from more mature lymphoid progenitor cells. Inbred mice also differ significantly in all aspects of haemopoiesis, and these differences have been used to identify quantitative trait loci (QTL) that determine the frequency of specific haemopoietic stem, progenitor or mature blood cells. The co-localization of QTL that determine risk and target cell frequency in all three haemopoietic malignancies is strong evidence that target cell frequency is a risk factor in radiation leukaemogenesis.
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Affiliation(s)
- M Jawad
- Department of Genetics, University of Leicester, University Road, Leicester LE1 7RH, UK
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17
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Ings SJ, Balsa C, Leverett D, Mackinnon S, Linch DC, Watts MJ. Peripheral blood stem cell yield in 400 normal donors mobilised with granulocyte colony-stimulating factor (G-CSF): impact of age, sex, donor weight and type of G-CSF used. Br J Haematol 2006; 134:517-25. [PMID: 17018030 DOI: 10.1111/j.1365-2141.2006.06223.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Mobilised peripheral blood is now the main source of stem cells collected from normal donors. We report our experience of mobilising and collecting 400 normal healthy donors using standardised procedures and techniques. Target recipient doses were reached with one aphaeresis in 63% of donors and with two aphereses in 81% of donors. Approximately 2% of donors yielded such low progenitor values that they were termed 'poor mobilisers'. There were minor effects of donor age, weight and sex and where possible, larger male donors under the age of 55 years should be selected. Two forms of granulocyte colony-stimulating factor (G-CSF) were used at the same dose and no significant difference was seen in the yield of CD34+ cells collected/l of blood processed. However, a greater number of granulocyte-macrophage colony-forming cells were harvested using lenograstim (glycosylated G-CSF) compared with filgrastim (non-glycosylated G-CSF; P = 0.002). CD34+ cell yields were also measured halfway through the aphaeresis procedure. This was found to be highly predictive of final yield and facilitated distribution of the stem cell product to other centres. The observation that CD34+ yields did not decline in the second half compared with the first half of aphaeresis suggests that the circulating cell numbers are not static.
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Affiliation(s)
- Stuart J Ings
- Royal Free and University College London Medical School, London, UK
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18
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Lysák D, Koza V, Jindra P. Factors affecting PBSC mobilization and collection in healthy donors. Transfus Apher Sci 2005; 33:275-83. [PMID: 16209935 DOI: 10.1016/j.transci.2005.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 07/30/2005] [Indexed: 10/25/2022]
Abstract
Peripheral blood stem cells are widely used as stem cell source for allografting. Progenitor cells can be effectively mobilized into peripheral blood in majority of healthy donors with a brief administration of G-CSF. A mobilization course in 111 donors (median age 40years) was retrospectively studied and the factors influencing the efficacy of mobilization were analyzed. The median number of CD34+ cells per kg recipient weight 5.1x10(6) was obtained after a median of two aphereses. The target cell dose (4.0x10(6)/kg) was reached in 69% of donors. Circulating CD34+ count and CD34+ yield were negatively associated with donor's age. Other independent factors associated with superior yield were precollection platelet and WBC counts. In multivariate analysis only CD34+ precount predicted for CD34+ yield. G-CSF had an acceptable short-term safety profile. Our data confirm that apheresis is a safe procedure in healthy including aged donors and suggest that older donors could be poorer mobilizers than younger.
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Affiliation(s)
- Daniel Lysák
- Department of Hematology and Oncology, Charles University Hospital, Alej Svobody 80, Plzen 304 60, Czech Republic.
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Vela-Ojeda J, Esparza MAGR, Reyes-Maldonado E, Jiménez-Zamudio L, García-Latorre E, Moreno-Lafont M, Estrada-García I, Mayani H, Montiel-Cervantes L, Tripp-Villanueva F, Ayala-Sánchez M, García-León LD, Borbolla-Escoboza JR. CD4+CD25+Lymphocyte and Dendritic Cell Mobilization with Intermediate Doses of Recombinant Human Granulocyte Colony-Stimulating Factor in Healthy Donors. Stem Cells Dev 2005; 14:310-6. [PMID: 15969626 DOI: 10.1089/scd.2005.14.310] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We prospectively conducted a quantitative and phenotypic analysis of T, B, natural killer (NK), NKT, type 1 and 2 dendritic cells (DC), and regulatory T cells, before and after mobilization with intermediate doses of granulocyte colony-stimulating factor (G-CSF) (16 microg/kg per day). Between November, 2003, and December, 2004, we collected stem cells from 25 HLA identical sibling donors for allogeneic hematopoietic stem cell transplantation. Before mobilization and 3 h after the fourth and fifth doses of G-CSF, blood samples were taken for blood counts and flow cytometry. The median number of regulatory T cells before and after G-CSF was statistically different (69 +/- 41 x 10(6)/L versus 161 +/- 159 x 10(6)/L, p < 0.01). We observed a 1.7-fold increase in NK and NKT cells (p < 0.009 and p < 0.02, respectively). DC were mobilized with a 11.5-fold increase in type 2 (p < 0.004) and a 8.5-fold increase in type 1 DC (p < 0.003). The patients received a mean of: 2.2 x 10(7)/kg +/- 1.4 x 10(7)/kg of NK cells, 0.95 x 10(7)/kg +/- 0.81 x 107/kg of NKT cells, 0.43 x 107/kg +/- 0.53 x 10(7)/kg of type 1 DC, 0.3 v 10(7)/kg +/- 0.45 x 10(7)/kg of type 2 DC and 1.4 x 10(7)/kg +/- 1.2 x 10(7)/kg of regulatory T cells. Using intermediate doses of G-CSF, we have demonstrated the mobilization of different lymphocyte subsets, in particular regulatory T cells and DC, which can be expanded later and used in the treatment of cancer and autoimmune diseases.
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Affiliation(s)
- J Vela-Ojeda
- Hematology Department, Stem Cell Transplant Program, Unidad Médica de Alta Especialiad Antonio Fraga Mouret Centro Médico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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Reddy RL. Mobilization and collection of peripheral blood progenitor cells for transplantation. Transfus Apher Sci 2005; 32:63-72. [PMID: 15737875 DOI: 10.1016/j.transci.2004.10.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 10/01/2004] [Indexed: 11/28/2022]
Abstract
Bone marrow transplantation gradually expanded as a treatment modality for various malignant and non malignant disease conditions. Since the discoveries of the potential of Peripheral Blood Progenitor Cells (PBPC) in the hematopoietic reconstitution mid 1980s and early 1990s PBPC gradually replaced bone marrow as the preferred source of stem cells. The introduction of hematopoietic cytokines that can mobilize large number of progenitors into circulation accelerated PBPC usage. Technological advancements in the apheresis instrumentation greatly helped in the conversion from marrow to PBPC. PBPC collection is less painful, less expensive and transplant with PBPC results in faster hematological recovery than with marrow. Almost all of the autologous transplants are currently performed with PBPC and a similar trend is seen with the allogeneic transplants. The progenitor cell mobilization regimen for autologous patients can be cytokines alone or cytokines combined with chemotherapy. In the majority of the patients the required minimal cell dose of 2.5-5.0 x 10(6)/kg CD34+ cells can be collected in one or two apheresis collections. A few of autologous transplant patients who mobilize poorly require several collections. Allogeneic donors are generally mobilized with daily subcutaneous injections of G-CSF 10 microg/kg for 5 days. The PBPC are collected in one or two apheresis procedures. The side effects of G-CSF are generally mild to moderate; however rare serious reactions including rupture of the spleen have been reported. The collection of PBPC in pediatric patients poses additional challenges yet an adequate dose of cells can be collected with the available apheresis instrumentation. The apheresis collection procedures are safe with no serious adverse consequences. Future scientific advancements may expand the use of PBPC for other clinical application in addition to the current use for hematological reconstitution.
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Affiliation(s)
- Ramakrishna L Reddy
- American Red Cross Midwest Region Blood Services and Department of Pathology and Microbiology, University of Nebraska Medical Center, 3838 Dewey Avenue, Omaha, NE 68105, USA.
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Abstract
Factors affecting collection efficiency of peripheral blood stem cells (PBSCs) include patient's age, diagnosis, preceding chemoradiotherapy, disease invasion of the bone marrow and mobilizing chemotherapy in PBSC collection for autologous transplants. Mobilizing cytokines, timing for apheresis, machines and operating software would affect mobilization and collection of PBSCs both for autologous and allogeneic transplantation. Also donor's age and gender would affect PBSC yield for allogeneic transplantation. Surrogate markers including peripheral blood CD34+ cell counts before mobilization and on day of collection have been reported to predict the yield of PBSC harvest. A number of standard procedures have been developed based on these findings. Newer agents for PBSC mobilization are being evaluated and still other factors affecting mobilization are being sought to better predict and cope with poor mobilization.
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Affiliation(s)
- Kazuma Ikeda
- Division of Blood Transfusion, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
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Sevilla J, González-Vicent M, Madero L, Díaz MA. Peripheral blood progenitor cell collection in low-weight children. JOURNAL OF HEMATOTHERAPY & STEM CELL RESEARCH 2002; 11:633-42. [PMID: 12201951 DOI: 10.1089/15258160260194776] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Peripheral blood progenitor cells (PBPC) are substituting bone marrow as a source of stem cells for either autologous or allogeneic hematopoietic transplantation. Several papers have been published on the experience of various groups in their mobilization and transplantation in children. Some technical problems have derived from the size of the patient or donor in the pediatric setting. Thereby, there is some concern regarding leukapheresis in very small children (weighing less than 15-20 kg). This paper summarizes our own data and that of other groups for the mobilization and collection of PBPC in the smallest children. Data from the literature show that mobilization with cytokines alone or in combination with chemotherapy is well tolerated by these patients. Pediatric donors may be used for allogeneic transplantation with no higher incidence of complications. PBPC collection even in the smallest children is a safe and efficient procedure when performed by experienced apheresis teams.
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Affiliation(s)
- Julián Sevilla
- Hospital Infantil Universitario Niño Jesús, Madrid, 28009 Spain.
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Kröger N, Zander AR. Dose and schedule effect of G-GSF for stem cell mobilization in healthy donors for allogeneic transplantation. Leuk Lymphoma 2002; 43:1391-4. [PMID: 12389618 DOI: 10.1080/10428190290033323] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the present review, we analyze the literature regarding the dose and schedule effects of granulocyte stimulating factor (G-CSF) for stem cell mobilization of healthy donors for allogeneic stem cell transplantation. There is now evidence for a dose and schedule dependency of G-CSF in mobilizing peripheral blood progenitor cells (PBSC) in healthy donors for allogeneic stem cell transplantation. In general, a dose between 10 and 16 microg/kg split into two doses is recommended. Leukapheresis should be performed on day 4 or 5. A higher dose of G-CSF might be appropriate in donors with low CD34+ baseline cell count (< 2000/ml) or if a high CD34+ cell number is required. However, a higher dose of G-CSF results in a higher acute toxicity like bone and muscle pain or headache. Severe adverse events like thromboembolic events, cerebrovascular incidents, anaphylactoid reactions and an atraumatic splenic rupture have been rarely reported. A prolonged follow-up of the donors is needed to rule out late toxicity of the donors.
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Affiliation(s)
- Nicolaus Kröger
- Department of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
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de la Rubia J, Arbona C, de Arriba F, del Cañizo C, Brunet S, Zamora C, Díaz MA, Bargay J, Petit J, de la Serna J, Insunza A, Arrieta R, Pascual MJ, Serrano D, Sanjuan I, Espigado I, Alegre A, Martínez D, Verdeguer A, Martínez C, Benlloch L, Sanz MA. Analysis of factors associated with low peripheral blood progenitor cell collection in normal donors. Transfusion 2002; 42:4-9. [PMID: 11896306 DOI: 10.1046/j.1537-2995.2002.00010.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Predictive factors of the response to rHuG-CSF in normal donors have not been extensively studied. STUDY DESIGN AND METHODS We analyzed factors influencing CD34+ cell yield in the 1st day of collection in 261 healthy donors from the Spanish National Donor Registry. The median age was 38 years (range, 2-72). The median dose of rHuG-CSF was 10 microg per kg per day (range, 5-20) over 4 days. In 103 donors (40%), <4 x 10(6) per kg CD34+ cells were collected. The variables that were analyzed included age, sex, weight, basal complete blood cell count, dose, type of rHuGCSF and schedule of administration, and maximum WBC count before apheresis. RESULTS By univariate analysis, the maximum WBC count (<50 vs. >or=50 x 10(9)/L, p = 0.004), advanced age (p = 0.008), and number of daily rHuG-CSF doses (one vs. two; p = 0.01) correlated with the number of CD34+ cells collected. By multivariate analysis, donors age (<38 vs. >or=38 years; p = 0.014) and a single daily dose of rHuG-CSF (p = 0.005) were the two variables that significantly predicted a low CD34+ cell yield. CONCLUSION Donors' age, with a threshold of 38 years or more, and the rHuG-CSF schedule are the factors that significantly affected CD34+ cell mobilization and collection in healthy donors.
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