Haematological malignancies in sibling and unrelated donors of allogeneic peripheral stem cells mobilised with G-CSF filgrastim: a transplant centre and Czech National Marrow Donors Registry experience
Abstract
G-CSF filgrastim is frequently used to mobilise CD34þ cells in donors before PBSC collection. Several observational reports raised concerns regarding an elevated risk of haematological malignancies after G-CSF administration.
It was found that treatment with G-CSF of PBSC donors induced chromosomal tetraploidy in a small subset of mature myeloid cells in the blood,1 epigenetic and genetic alterations in lymphocytes2 and aneuploidy.3 In 2006, Bennett et al.4 reported two cases of AML identified in the sibling donors, whose recipients also suffered with AML, among 200 individuals who had received filgrastim before collection of PBSC for allogeneic transplantation. In a large retrospective EBMT analysis, Halter et al.5 observed 20 haematological malignancies (3.92/10 000), of which 12 were after donating PBSC; however, the observed incidence rate did not exceed the expected incidence in an age- and sex-adjusted general population, and there was no relationship with the type of haematological malignancy in the recipients and donors donating for siblings.
We decided to conduct an analysis of follow-up policy and aematological malignancy incidence in related sibling donors of allogeneic PBSC mobilised with G-CSF filgrastim in the period of 2001–2010 at our transplant centre (TC), and to compare the results with those of unrelated donors of the Czech National Marrow Donor Registry (CNMDR).