Burak UZ, Hakan GÖKER, Yahya BÜYÜKAŞIK, Salih AKSU, Nilgün SAYINALP, C. İbrahim HAZNEDAROĞLU, Fatma TEKİN, Sevilay ÜNAL, Mehmet TURGUT, İ. Osman ÖZCEBE

Filgrastim ve lenograstimin sağlıklı donörlerde periferik kan kök hücre mobilizasyonu üzerine etkilerinin karşılaştırılması

Amaç: Granülosit koloni-uyarıcı faktör (G-CSF) nötro-peni tedavisinde ve otolog ve allojeneik transplantasyon öncesi periferik kan kök hücre mobilizasyonunda yaygın olarak kullanılmaktadır. Nötropeninin süresini kısaltır ve böylece nötropenik ateşin sıklığını azaltır. Bu çalışmada filgrastim ve lenograstimin CD34+ kök hücre mobilizas-yonundaki etkinliğini kıyaslamayı amaçladık. Materyal ve Metot: Çeşitli hematolojik maliniteli hasta-ların allojeneik donörü olan 130 sağlıklı bireye mobili-zasyon amacıyla filgrastim (n=103) veya lenograstim (n=27) 5 gün boyunca uygulandı. Altıncı gün periferik kandan CD34+ kök hücre aferezi yapıldı. Results: Ortalama G-CSF dozu filgrastim için 5,33±1,38 MIU, lenograstim içinse 5,65±1,91 MIU idi. Aferez siklusu başına CD34+ ürün miktarı (6,88±0,47x106/kg; 5,90± 0,74x106/kg, p=0,335), nötrofil (11.43±0,29; 11.96± 0,42, p=0,382) ve trombosit (12,77±0,47; 12,38 ±0,90, p=0,709) engrafman günleri açısından iki grup arasında anlamlı farklılık saptanmadı. Aferez başına CD34+ ürün miktarı ile nötrofil engrafman zamanı donör yaşı (sıra-sıyla p=0,257, r=-0,101; p=0,164, r=0,123) ve donör kilosu (sırasıyla p=0,540, r=0,058; p=0,454, r=-0,070) ile korelasyon göstermedi. Ek olarak, aferez başına CD34+ ürün miktarı filgrastim (p=0,107, r=0,173) veya lenogras-tim dozu/kg (p=0,543, r=-0,145) ile korele değildi. Aferez cihazının tipi CD34+ ürün miktarını etkilemedi (p=0,535). Sonuç: Filgrastim ve lenograstim periferik kan kök hücre mobilizasyonunda benzer etkilere sahip bulundu.

Comparison of filgrastim and lenograstim on mobilization of peripheral blood stem cells in healthy donors

Objective: Granulocyte colony-stimulating factor (G-CSF has been widely used to treat neutropenia and peripheral blood stem cell mobilization. It shortens neutropenia and thus reduces the frequency of neutropenic fever. Material and Method: A total of 130 healthy allogeneic donors were enrolled for mobilization with either filgrastim (n=103) or lenograstim (n=27) for 5 consecutive days. The peripheral blood CD34+ apheresis was done on the 6th day. Results: The mean dose of G-CSF/kg was 5.33±1.38 MIU for filgrastim and 5.65±1.91 MIU for lenograstim. No significant difference was seen in the median number of CD34+ cell yield per apheresis cycle mobilized (6.88 ±0.47 x106/kg vs 5.90±0.74 x 106/kg, p=0.335). Neutrophil (11.43±0.29 vs 11.96±0.42, p=0.382) and platelet engraftment days (12.77±0.47 vs 12.38± 0.90, p=0.709) were similar in both groups. Number of CD34+ cell yield per apheresis cycle and neutrophil engraftment in days did not corralete with donor age (p= 0.257, r=-0.101; p=0.164, r=0.123, respectively) and donor weight (p=0.540, r=0.058; p=0.454, r=-0.070, respectively). The number of CD34+ cell yield per apheresis cycle did not corralate with G-CSF dose/kg either with filgrastim (p=0.107, r=0.173) or lenograstim (p=0.543, r=-0.145). The type of the apheresis device did not effect the CD34+ yield (p=0.535). Conclusion: Filgrastim and lenograstim were found to have similar effects on allogeneic peripheral blood stem cell mobilization.

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