Transient spleen enlargement in peripheral blood progenitor cell donors given G-CSF

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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.

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Publié le 01 janvier 2004
Nombre de lectures 13
Langue English
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Journal of Translational Medicine
BioMedCentral
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
Published: 21 July 2004Received: 26 June 2004 Accepted: 21 July 2004 Journal of Translational Medicine2004,2:25 doi:10.1186/1479-5876-2-25 This article is available from: http://www.translational-medicine.com/content/2/1/25 © 2004 Stroncek et al; licensee BioMed Central Ltd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
granulocyte colonystimulating factorperipheral blood progenitor cellssplenomegalyspleen
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 colonystimulat ing factor (GCSF) 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 GCSF are given subcutaneously daily for 4 to 6 days prior to the collection [13]. The administration of GCSF 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 GCSF [47].
While spontaneous rupture of the spleen in PBSC donors given GCSF is rare, the administration of GCSF 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 GCSF for 5 days, we found that spleen length measured four days after the last dose of GCSF 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
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