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

Objectives: To determine the optimal time schedule for neutrophil collection after single mobilization with glycosylated recombinant granulocyte colony-stimulating factor (G-CSF, lenograstim) with or without dexamethasone (DXM). Donors and Methods: In this prospective randomized trial, 26 healthy volunteers were randomly assigned to a single subcutaneous dose of lenograstim 6 mu g/kg plus 8-mg DXM (G-CSF/DXM, n = 13) or placebo (G-CSF/placebo, n = 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. Results: Polymorphonuclear neutrophil (PMN) counts 12 and 21 h after mobilization were 22.7 (16.6-32.8) x 109/L and 22.4 (18.6-30.6) x 109/L for G-CSF/placebo versus 33.1 (24.244.9) x 109/L and 32.5 (17.439.6) x 109/L for G-CSF/DXM. This mobilization plateau was followed by slow normalization at 7284 h. The six NA subjects had median PMN yields of 62 (47101) x 109 and 39 (2342) x 109 per therapeutic unit. After the first apheresis, PMN counts sharply decreased to 21.1 (14.826.3) x 109/L and then temporarily recovered to 25.9 (18.936.5) x 109/L (P = 0.001) over the next 8 h. Conclusions: Single doses of lenograstim with or without DXM induced a PMN plateau that lasted 9 h (1221 h after mobilization), with PMN counts suitable for neutrophil collection. Lenograstim plus DXM made it possible to perform NA twice, 12 and 36 h after mobilization. (C) 2011 Wiley Periodicals, Inc.