Dose and schedule effect of G-GSF for stem cell mobilization in healthy donors for allogeneic transplantation.

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.