[Administration of leukemic granulocyte colony-stimulating factor to donors: the changes in donor bone marrow cell composition and the transplantation outcome]

Abstract

Objective: To investigate the change of bone marrow cell composition the effect of graft on hemopoietic reconstitution and the incidence of acute graft-versus-host disease (aGVHD) with granulocyte colony-stimulating factor G-CSF administration to donors before marrow harvesting.

Methods: Twenty-four patients with myeloid leukemia underwent allogeneic bone marrow transplantation. The donors of twelve patients (study group) were given G-CSF 250 microg/d for seven days prior to harvesting. The marrow cell composition, the outcome of subsequent engraftment and the occurrence of aGVHD were compared with those in twelve patients without G-CSF (control group).

Results: The bone marrow stimulated by G-CSF yielded higher number of nucleated cells, CD34+ cells, CFU-GM and CFU-MK (P < 0.01). The number of T lymphocyte subsets in the graft stimulated with G-CSF was different from that in the control group. The number of CD4+ cells was decreased and that of CD8+ increased. The CD4+/CD8+ ratio was reduced markedly (P < 0.01). The change of CD34+, CD4+, CD8+ percentage and CFU-GM, CFU-MK proliferation in donor bone marrow with and without G-CSF was compared. The same characteristic change as above graft was observed. Hemopoietic reconstitution in the study group after allo-BMT was accelerated. In the study group the days of granulocyte count exceeding 0.5 x 10(9)/L and platelet count exceeding 20 x 10(9)/L were 16 days (range 11 - 23 days) and 17 days (range 14 - 25 days) (in the control group 20.5 day, range 14 - 29 days and 23 days, range 17 - 32 days P < 0.05). Grade II - IV aGVHD did not occur in patients of the study group but in 3 patients of the control group.

Conclusion: The bone marrow harvested from donor with G-CSF stimulation can accelerate hemopoietic recovery and decrease the incidence of severe aGVHD. The accelerated hematopoietic recovery is associated with increased number of CD34+, CFU-GM and CFU-MK in the graft.