Safety and feasibility of granulocyte colony-stimulating factor (G-CSF) primed bone marrow (BM) using three days of G-CSF priming as stem cell source for pediatric allogeneic BM transplantation

There are limited data on the optimal dosing and schedule of G-CSF priming prior to BM harvest. We evaluated the safety and efficacy of three days of G-CSF of primed BM from related pediatric donors. Forty-five children were treated. All donors received 5 μg/kg per day of G-CSF as a single subcutaneous injection for three consecutive days prior to the BM harvest. The median age of the donors was seven yr (range, 0.8–18) and no donor experienced major adverse events related to G-CSF administration. The median age for the recipients was five yr (0.3–16 yr). Thirty-five patients had non-malignant disorders. The median dose of nucleated (TNC) and CD34+, CD3 cells infused per recipient weight was 5.4 × 10⁸/kg (range, 0.61–17), 4.7 × 10⁶/kg (range, 1.6–19), and 43.8 × 10⁶/kg (range, 1.8–95), respectively. All patients achieved neutrophil and platelets engraftment, at a median of 15 (range, 10–22) and 23 days (range, 13–111), respectively. At a median follow up of 60 months (range 12–100), the estimated five yr overall and EFS was 91% and 80%, respectively. Collection of BM following three days of G-CSF priming from pediatric donors is safe and results in high TNC and CD34+ cell yield.