A dose‐response analysis of lenograstim plus dexamethasone for neutrophil mobilization and collection

Abstract

The most effective dose-response ratio for PMN mobilization was demonstrated in the 6 microg per kg lenograstim group. In neutropenic adults, GTX treatment on an every-other-day schedule may be ineffective.

Efficacy and Side Effects of Granulocyte Collection in Healthy Donors

“…Our standard mobilization regimen of 5.0-7.0 µg/kg body weight of lenograstim and 4 mg of dexamethasone was very effective in obtaining high granulocyte yields and PMN counts for subsequent transfusion, which were consistent with those obtained in previous studies [19,20,21,22,23,24]. Higher doses of lenograstim did not result in significantly higher granulocyte yields but increased the rate of side effects as shown by a study of Heuft et al [26]. Granulocyte yields from donors mobilized with a combination of 3.69-4.98 µg/kg body weight (median 4.33 µg/kg body weight) of lenograstim and 4 mg of dexamethasone were similar to yields from donors administered higher lenograstim doses (5.0-7.0 µg/kg body weight).…”

“…The decrease in Hb levels is not found in PBSC donors and can be explained by the significant loss of erythrocytes during granulocyte donation. In contrast, a greater reduction in WBCs is observed in PBSC donors - median WBC of 5.1 × 10 9 /l and median PMN 2.9 × 10 9 /l [25] have been reported 4 weeks after donation [22,26]. The reason for this remains unclear, but others have proposed that it may involve depletion of slowly self-renewing hematopoietic stem cells, down-regulation of the G-CSF receptor, or another alteration of cytokine signaling [25,32].…”

Lenograstim with or without dexamethasone for neutrophil mobilization in healthy donors: Short‐term kinetics of white blood cells and effects of granulocyte apheresis

“…significantly increase median peripheral blood PMN counts from 24.5 3 10 9 /L (1.5 lg/kg) by $4,000/lL stepwise to 32. 8 3 10 9 /L (6 lg/kg), and that dose escalation to 12 lg/kg does not improve the median PMN response (33.0 3 10 9 /L) [24]. We also demonstrated that the neutrophil mobilization capacity of LENO is so potent that neutrophil concentrates can even be collected twice, 16 and 42 h after a single dose of LENO plus DXM (LENO/DXM), with acceptable PMN yields [25].…”

“…In a large-scale trial including 260 healthy donors, we evaluated the neutrophil mobilization capacity of LENO over a wide range of median doses (1.5, 3, 6, and 12 lg/kg) [19,24]. We previously showed that single doses of LENO s.c. plus 8-mg DXM p.o.…”

“…Donors and Methods: In this prospective randomized trial, 26 healthy volunteers were randomly assigned to a single subcutaneous dose of lenograstim 6 lg/kg plus 8-mg DXM (G-CSF/DXM, n 5 13) or placebo (G-CSF/placebo, n 5 13). Hematological and biochemical parameters were analyzed before and 12, 15,18,21,24,27,29, 36, 48, 60, 72, and 84 h and 7 and 30 days after mobilization. Six G-CSF/DXM subjects underwent standard neutrophil apheresis (NA) 12 and 36 h after mobilization.…”