The administration of granulocyte colony-stimulating factor (G-CSF) to peripheral blood progenitor cell (PBPC) donors causes spleen length to increase, but the duration of enlargement is not known. Eighteen healthy subjects were given 10 μg/kg of G-CSF for 5 days and a PBSC concentrate was collected by apheresis. Ultrasound scans were used to assess craniocaudal spleen length before and after G-CSF administration. Mean spleen length increased from a baseline length of 10.7 ± 1.3 cm to 12.1 ± 1.2 cm on the apheresis day (p < 0.001). Ten days after apheresis, spleen length fell to 10.5 ± 1.2 cm and did not differ from baseline levels (p = 0.57), but in 3 subjects remained 0.5 cm greater than baseline length. Increases in spleen length in PBPC donors are transient and reversible.
Open Access Research Transient spleen enlargement in peripheral blood progenitor cell donors given G-CSF 1 12 David F Stroncek*, Kristin Dittmar, Thomas Shawker, 1 1 Angela Heathermanand Susan F Leitman
1 Address: Departmentof Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA and 2 Department of Diagnostic Radiology, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA Email: David F Stroncek* dstroncek@cc.nih.gov; Kristin Dittmar kdittmar@cc.nih.gov; Thomas Shawker tshawker@cc.nih.gov; Angela Heatherman aheatherman@cc.nih.gov; Susan F Leitman sleitman@cc.nih.gov * Corresponding author
Abstract The administration of granulocyte colony-stimulating factor (G-CSF) to peripheral blood progenitor cell (PBPC) donors causes spleen length to increase, but the duration of enlargement is not known. Eighteen healthy subjects were given 10µg/kg of G-CSF for 5 days and a PBSC concentrate was collected by apheresis. Ultrasound scans were used to assess craniocaudal spleen length before and after G-CSF administration. Mean spleen length increased from a baseline length of 10.7 ± 1.3 cm to 12.1 ± 1.2 cm on the apheresis day (p < 0.001). Ten days after apheresis, spleen length fell to 10.5 ± 1.2 cm and did not differ from baseline levels (p = 0.57), but in 3 subjects remained 0.5 cm greater than baseline length. Increases in spleen length in PBPC donors are transient and reversible.
Background Peripheral blood progenitor cell (PBPC) concentrates donors are routinely given granulocyte colonystimulat ing factor (GCSF) to increase the concentration of circu lating PBPCs and hence the number of progenitors that can be collected by apheresis. Typically 10 to 16µg/kg of GCSF are given subcutaneously daily for 4 to 6 days prior to the collection [13]. The administration of GCSF to healthy PBPC concentrates donors is very safe, but there have been four reports of spontaneous rupture of the spleen and splenectomy in healthy allogeneic PBPC donors given GCSF [47].
While spontaneous rupture of the spleen in PBSC donors given GCSF is rare, the administration of GCSF for five days causes spleen length to increase in almost all healthy donors [8,9]. The increase in length is highly variable, but the mean increase is approximately 13%. Spleen length begins to return to baseline levels quickly, but it is not known how long it takes to return to baseline. In a previ ous study of 20 PBPC donors given 10µg/kg of GCSF for 5 days, we found that spleen length measured four days after the last dose of GCSF was less than the length on the day of apheresis but greater than baseline values [8].
Since allogeneic PBPC donors may be at risk for splenic rupture while the spleen is enlarged, it is important to
Page 1 of 4 (page number not for citation purposes)