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Graft-Versus-Host Disease

Reduced risk of acute GVHD following mobilization of HLA-identical sibling donors with GM-CSF alone

Bone Marrow Transplantation volume 36, pages 531–538 (2005)Cite this article

Summary:

We retrospectively reviewed the results of transplanting peripheral blood progenitor cell (PBPC) allografts from HLA-matched sibling donors mobilized using various hematopoietic cytokines. Patients had received allografts mobilized with Granulocyte colony-stimulating factor (G-CSF) (G, N=65) alone, G plus Granulocyte-macrophage colony stimulating factor (GM-CSF) (G/GM, N=70), or GM-CSF alone at 10 or 15 μg/kg/day (GM, N=10 at 10 μg/kg/day and 21 at 15 μg/kg/day). The CD34+ and CD3+ cell content of grafts were significantly lower following GM alone compared to G alone (P<0.001 and 0.04, respectively). Nonhematopoietic toxicity observed in donors precluded dose escalation of GM-CSF beyond 10 μg/kg/day. Hematopoietic recovery was similar among all three groups. Grades II–IV acute graft-versus-host disease (GVHD) was observed in only 13% of patients in the GM alone group compared to 49 and 69% in the G alone or G/GM groups, respectively (P<0.001). In a multivariate analysis, receipt of PBPC mobilized with GM alone was associated with a lower risk of grades II–IV acute GVHD (hazard ratio 0.21; 95% CI 0.073, 0.58) compared to G alone or G/GM. There were no differences in relapse risk or overall survival among the groups. Donor PBPC grafts mobilized with GM-CSF alone result in prompt hematopoietic engraftment despite lower CD34+ cell doses and may reduce the risk of grades II–IV acute GVHD following HLA-matched PBPC transplantation.

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Acknowledgements

This study was supported (in part) by research funding from Berlex Inc. to SMD.

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  1. S M Devine and R A Brown: Both these authors contributed equally to this study.

Authors and Affiliations

  1. Siteman Cancer Center and Department of Medicine, Division of Oncology, Section of Stem Cell Transplantation, Leukemia, and Stem Cell Biology, Washington University School of Medicine, St Louis, MO, USA

    S M Devine, R A Brown, V Mathews, K Trinkaus, H Khoury, D Adkins, R Vij, D Sempek, T Graubert, M Tomasson, L T Goodnough & J F DiPersio

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Correspondence to S M Devine.

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Devine, S., Brown, R., Mathews, V. et al. Reduced risk of acute GVHD following mobilization of HLA-identical sibling donors with GM-CSF alone. Bone Marrow Transplant 36, 531–538 (2005). https://doi.org/10.1038/sj.bmt.1705091

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