Peripheral blood stem cell mobilization and apheresis: analysis of adverse events in 94 normal donors
Peripheral blood stem cell mobilization and apheresis: analysis of adverse events in 94 normal donors
复制标题
DOI：
10.1038/sj.bmt.1702038
复制
发表时间：
1999-11-01
影响因子：
4.8
通讯作者：
Kodera, Y
中科院分区：
文献类型：
--
作者：
Murata, M;Harada, M;Kodera, Y
在94例接受G-CSF采集的正常供体中分析了不良事件。G-CSF的中位剂量为9.7 μ g/kg/天（范围2.0-16.7），给药持续时间为4-6天。常见症状为骨痛（71%）、全身乏力（33%）、头痛（28%）、失眠（14%）、厌食（11%）、恶心和/或呕吐（11%），1例供体（1%）发生3级毒性骨痛（WHO标准）。G-CSF给药期间WBC计数和ANC升高。白细胞去除术后，3名供体（3%）发生3级毒性中性粒细胞减少，白细胞去除术后血小板计数下降。3名供体（3%）发生3级血小板减少症，ALP和LDH的平均值均较治疗前水平增加约1.9倍。在一名儿童供体（1%）中，ALP升高至3级毒性水平。多变量分析显示，当G-CSF的剂量为8.8 μ g/kg/d或更高时，骨痛的发生率增加，35岁以下的供体中头痛频繁，女性供体中恶心和/或呕吐的发生率较高。WBC计数和ANC的峰值水平以及治疗后LDH水平随G-CSF剂量的增加而增加。所有不良事件在随访评价时均正常化。总之，虽然正常供体的PBSC收获是可以接受的，但必须注意所有供体的性别和年龄以及G-CSF剂量。我们建议正常供体PBSC动员的G-CSF剂量低于8.8 μ g/kg/天。
Adverse events were analyzed in 94 normal donors who underwent PBSC harvest with G-CSF. The median dose of G-CSF was 9.7 mu g/kg/day (range, 2.0-16.7), and the duration of administration was 4-6 days. Frequent symptoms were bone pain (71%), general fatigue (33%), headache (28%), insomnia (14%), anorexia (11%), nausea and/or vomiting (11%), One donor (1%) developed grade 3 toxicity bone pain (WHO criteria). WBC counts and ANC increased during G-CSF administration. After leukapheresis, three donors (3%) developed grade 3 toxicity neutropenia, Platelet counts decreased after leukapheresis. Three donors (3%) developed grade 3 thrombocytopenia, The means of both ALP and LDH increased approximately 1.9-fold compared with pretreatment levels. In one pediatric donor (1%), ALP was elevated to the grade 3 toxicity level. From multivariate analysis, the incidence of bone pain increased when G-CSF was given at a dose of 8.8 mu g/kg/day or more, headaches were frequent in donors younger than 35 years, and the incidence of nausea and/or vomiting was high in female donors. The peak levels of WBC counts and ANC and post-treatment level of LDH increased in correspondence with the escalation of G-CSF dose. All adverse events normalized on follow-up evaluation. In conclusion, although PBSC harvest for normal donors is acceptable, care must be taken for all donors in terms of their sex and age as well as the G-CSF dose. We recommend less than 8.8 mu g/kg/day as the G-CSF dose for PBSC mobilization in normal donors.