Abstract | BACKGROUND: The use of granulocyte-colony-stimulating factor ( G-CSF) for mobilization, collection, and transplantation of autologous hematopoietic progenitor cells (HPCs) in patients with hemoglobinopathies can be complicated by severe vasoocclusive crises. Erythrocytapheresis before G-CSF administration may help prevent these complications. To date, no cases regarding the safety and outcome of erythrocytapheresis followed by autologous high-dose G-CSF mobilization in hemoglobinopathy populations have been reported. STUDY DESIGN AND METHODS: RESULTS: Erythrocytapheresis reduced the patient's combined Hb S and C levels to less than 20 percent. Subsequent HPC mobilization and peripheral blood harvesting using high-dose G-CSF yielded approximately 9 x 10(6) CD34+ HPCs per kg over 3 days of collection. Mobilization and leukapheresis were completed without vasoocclusive complications. Two weeks after collection, and after myeloablative chemotherapy, 5.33 x 10(6) CD34+ HPCs per kg were infused to the patient; platelet and white cell engraftment occurred, respectively, on Days +9 and +10 posttransplant. The patient experienced no vasoocclusive complications in the posttransplant period. CONCLUSIONS: The results of this case demonstrate that erythrocytapheresis before high-dose G-CSF HPC mobilization and collection appears to be an effective means for prevention of vasoocclusive crisis in patients with hemoglobinopathies undergoing autologous stem cell transplantation.
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Authors | Christopher A Tormey, Edward L Snyder, Dennis L Cooper |
Journal | Transfusion
(Transfusion)
Vol. 48
Issue 9
Pg. 1930-3
(Sep 2008)
ISSN: 1537-2995 [Electronic] United States |
PMID | 18513256
(Publication Type: Case Reports, Journal Article)
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Topics |
- Blood Component Removal
- Erythrocyte Transfusion
(methods)
- Female
- Hematopoietic Stem Cell Mobilization
(methods)
- Hematopoietic Stem Cell Transplantation
(methods)
- Hemoglobin SC Disease
(blood, therapy)
- Humans
- Middle Aged
- Multiple Myeloma
(blood, therapy)
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