To evaluate the schedule dependency of granulocyte colony-stimulating factor (G-CSF) (filgrastim) for stem cell mobilization, we conducted a randomized comparison in 50 healthy donors, with one subcutaneous daily injection of 10 microg/kg G-CSF (n = 25) compared with twice injections daily of 5 microg/kg G-CSF (n = 25). The two groups were well balanced for age, body weight and sex. G-CSF application was performed on an out-patient basis and leukapheresis was started in all donors on day 5. The most frequent side-effects of G-CSF were mild to moderate bone pain (88%), mild headache (72%), mild fatigue (48-60%) and nausea (8%) without differences between the two groups. The CD34(+) cell count in the first apheresis was 5.4 x 10(6)/kg donor weight (range 2.8-13.3) in the 2 x 5 microg/kg group compared with 4.0 x 10(6)/kg (range 0.4-8.8) in the 1 x 10 microg/kg group (P = 0.007). The target of collecting > 3.0 x 10(6) CD34(+) cells/kg donor weight with one apheresis procedure was achieved in 24/25 (96%) donors in the 2 x 5 microg/kg group and in 17/25 (68%) donors in the 1 x 10 microg/kg group. The target of collecting > 5.0 x 10(6) CD34(+) cells/kg in the first apheresis was achieved in 64% in the 2 x 5 microg/kg group, but in only 36% in the 1 x 10 microg/kg group. The progenitor cell assay for granulocyte-macrophage colony-forming units (CFU-GM) and erythroid burst-forming units (BFU-E) was higher in the 2 x 5 microg/kg group than in the 1 x 10 microg/kg group (7.0 vs. 3.5 x 10(5)/kg, P = 0.01; 6.6 vs. 5.0 x 10(5)/kg; P = 0.1). Administering G-CSF (filgrastim) at a dosage of 5 microg/kg twice daily rather than 10 microg/kg once daily is recommended; this leads to a higher CD34(+) cell yield and requires fewer apheresis procedures without increasing toxicity or cost.
Previous research was sceptical of the efficacy of planning in the case of avoiding goals in healthy eating. However, our results show that planning is an efficient intervention that can be used by health education programmes to reduce fat intake and, therefore, increase citizen well-being. These results also support the existence of a key variable in the implementation intentions process, that is, goal complexity, and the presence of two moderating variables, that is, gender and monitoring. Statement of contribution What is already known on this subject? Implementation intentions are action plans subordinate to goal intentions that specify the 'when, where, and how' of responses leading to goal attainment. In healthy eating, the average effect of forming implementation intentions is small to medium, but this efficacy changes depending on the type of intended behaviour. Past evidence shows that the effect size seems to be lower when the intervention aims at reducing unhealthy behaviours versus promoting healthy behaviours. What does this study add? Forming implementation intentions is an efficient intervention to reduce fat intake with a medium overall effect. The efficacy of this intervention is increased when men are targeted and when there is no monitoring during the process. This study introduces a new line of research focused on the study of the effect of planning on complex goals.
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