A prospective study of G-CSF-primed bone marrow as a stem-cell source for allogeneic bone marrow transplantation in children: A Pediatric Blood and Marrow Transplant Consortium (PBMTC) study

Haydar Frangoul, Eneida R. Nemecek, Dean Billheimer, Michael A. Pulsipher, Shakila Khan, Ann Woolfrey, Becky Manes, Catherine Cole, Mark C. Walters, Mouhab Ayas, Yaddanapudi Ravindranath, John E. Levine, Stephan A. Grupp

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44 Scopus citations

Abstract

A prospective multicenter trial was conducted to evaluate the safety and feasibility of granulocyte colony-stimulating factor (G-CSF)-primed bone marrow (G-BM) in children receiving allogeneic bone marrow transplantation (BMT). A total of 42 children with a median age of 9.8 years (range, 0.8-17 years) were enrolled. Donors with median age of 9.2 years (range, 1.1-22 years) received 5 μg/kg per day of subcutaneous G-CSF for 5 consecutive days. BM was harvested on the fifth day. No donor experienced complications related to G-CSF administration or marrow harvest. Median nucleated (NC) and CD34 cells infused was 6.7 × 108/kg (range, 2.4-18.5 × 108/kg) and 7.4 × 106/kg (range, 2-27.6 × 106/kg), respectively. Neutrophil and platelet engraftment was at a median of 19 days (range, 13-28 days) and 20 days (range, 9-44 days), respectively. A total of 13 (32%) patients developed grade 2 graft-versus-host disease (GVHD), and 5 (13%) of 40 evaluable patients developed chronic GVHD (3 limited and 2 extensive). Higher cell dose was not associated with increased risk of acute or chronic GVHD. Overall survival and event-free survival at 2 years were 81% and 69%, respectively. Collection of G-BM from pediatric donors is safe, and can result in high NC and CD34 cell doses that facilitate engraftment after myeloablative BMT without a discernable increase in the risk of GVHD.

Original languageEnglish (US)
Pages (from-to)4584-4587
Number of pages4
JournalBlood
Volume110
Issue number13
DOIs
StatePublished - Dec 15 2007

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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