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Blood, 1 February 2002, Vol. 99, No. 3, pp. 850-855
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Mobilization, collection, and processing of peripheral blood stem
cells in individuals with sickle cell trait
Elizabeth M. Kang,
Ellen M. Areman,
Virginia David-Ocampo,
Courtney Fitzhugh,
Mary E. Link,
Elizabeth J. Read,
Susan F. Leitman,
Griffin P. Rodgers, and
John F. Tisdale
From the Molecular and Clinical Hematology Branch,
National Institute of Diabetes, and Digestive and Kidney Disorders, and
the Department of Transfusion Medicine, Clinical Center, National
Institutes of Health, Bethesda, MD.
Mobilized peripheral blood is increasingly used as the source of
hematopoietic stem cells for allogeneic transplantation, currently the
only curative approach for sickle cell anemia. However, the safety and
feasibility of stem cell mobilization in individuals with sickle cell
trait (SCT) has not been documented. This study is a prospective
controlled trial to evaluate the safety and feasibility of peripheral
blood stem cell (PBSC) mobilization in 8 SCT subjects and 8 control
subjects matched for age and race. Mobilization with filgrastim 10 µg/kg subcutaneous daily for 5 days was followed by 12-L apheresis on
the fifth day. Filgrastim administration was accompanied by similar
symptoms in all subjects; no untoward adverse events occurred in either
group, including sickle cell crises. CD34+ cell
mobilization response was not significantly different between SCT and
control subjects. Median CD34+ cell content was also
similar in PBSCs collected from SCT versus control subjects, 6.8 versus
3.9 ×106 CD34+ cells/70 kg,
P = .165. Red cell depletion from SCT products was not
possible by using hydroxyethyl starch sedimentation but was achievable
with ammonium chloride lysis. There was no evidence of gelling of SCT
products after thaw, and no difference in cell recovery was seen among
red cell-depleted versus nondepleted products. Cryopreservation in 5%
dimethyl sulfoxide/6% pentastarch was associated with superior cell
recovery (both SCT and control subjects) compared with 10% dimethyl
sulfoxide (P = .001). The study concluded that filgrastim
mobilization, large volume apheresis, processing, and cryopreservation
appears to be safe in donors with SCT, allowing PBSC use for
transplantation in patients with sickle cell anemia.
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