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Safety of Stem Cell Mobilization in Donors with Sickle Cell Trait
The safety of stem cell mobilization using high dose granulocyte-colony stimulating factor has not been established in stem cell donors with sickle cell trait (SCT). Herein, we aimed to estimate the incidence of adverse events related to stem cell mobilization in donors with SCT in comparison to normal donors.
Methods
In this retrospective matched case control study, we enrolled 12 consecutive stem cell transplant donors with SCT (cases) and 12 age and gender matched donors with normal Hemoglobin electrophoresis (controls) between January 2007 and May 2013. We reviewed the health records for reported adverse events. We compared the incidence of adverse events using the appropriate statistical tests. We use filgrastim 10 microgram/kg subcutaneously daily for 6 days and collect the peripheral blood stem cells on day 6 after 2 hours of the last filgrastim dose.
Results
Both groups had similar baseline characteristics. There were 6 males and 6 females in each group, with mean age of 17 years in SCT donors and 19 years in non-SCT donors. The mean weight was 57 and 63 Kg for SCT and non-SCT donors respectively. There was no statistically significant difference between the two groups in the reported adverse events including bone pain, headache, myalgia and parasthesia. In the SCT donors group, three donors had headache, one had bone pain and one had parasthesia. In the non-SCT control group, two donors had headache, two had bone pain and one had myalgia. None of donors had chest pain, seizures, bleeding, nausea, vomiting, infection, splenic rupture, carpal-tunnel syndrome or blood transfusion. There were no reported deaths. The mean CD34 positive cell count measured on day 6 of mobilization was 98.2 x 106 /L (+/- 87.10) in the SCT group compared to 81.87 x 106 /L (+/- 78.71) in the non-SCT control group (P=0.81).
Conclusion
The observed incidence of adverse events in SCT-donors in relation to stem cell mobilization is very low, and is not higher than in non-SCT donors. Donors with SCT can be considered for stem cell mobilization. However, prospective and larger studies are needed to confirm the safety of stem cell mobilization in this group.