rHuG-CSF increases the platelet-neutrophil complex formation and neutrophil adhesion molecule expression in volunteer granulocyte and stem cell apheresis donors.

Several reports have shown that granulocyte colony-stimulating factor (G-CSF) administration induces a transient, mild hypercoagulable state, which might predispose certain donors to thrombotic complications. In the present study, changes in the expression of neutrophil adhesion molecules (CD11b/CD18, CD62L) and platelet-neutrophil complex formation following rHuG-CSF administration were investigated in normal granulocyte and stem cell donors. For granulocyte apheresis (N = 10), rHuG-CSF (5 microg/kg) was given subcutaneously every 12 h three times and apheresis was carried out two hours after the last dose. For stem cell apheresis (N = 8), rHuG-CSF (10 microg/kg/day) was given subcutaneously for 5 days and apheresis was carried out when peripheral CD34+ cell counts exceeded 20 cell/microL. Expression of neutrophil adhesion molecules (CD11b/CD18, CD62L) and platelet-neutrophil complex formation following rHuG-CSF administration were investigated in donors by a flow cytometric method. A significant increase in neutrophil counts (P < 0.001), and decreases in platelet counts (P < 0.01) and hemoglobin levels (P < 0.01) occurred following G-CSF administration. The expression of CD11b/CD18 significantly increased (P < 0.001) over pretreatment values with G-CSF administration and returned to baseline 1 week after stopping the drug. In contrast, CD62L expression was decreased (P < 0.01) with G-CSF and returned to normal after cessation of the drug. rHuG-CSF caused more than a two-fold increase (from 0.3 to 7.0 x 10(9)/L) in circulating platelet-neutrophil complexes (P < 0.01), which returned to normal after 1 week. Although clinical significance of these laboratory changes is not clear, the occurrence of neutrophil activation and increased platelet-neutrophil complex formation might predispose certain donors or patients to thrombotic complications following G-CSF administration.

Different desferrioxamine usage in the patients with thalassemia major: a cost-effect analysis.

Regular desferrioxamine (DFO) usage in patients with thalassemia major (TM) ameliorates hepatic, cardiac and endocrine dysfunction, improves growth and sexual maturation and prolongs survival. The difficulties of administering DFO with classic pumps are well known. The aim of this study was to compare the iron accumulation and cost effects between the continuous 48 hours infusion of DFO with infusor pump and the intermittent 40 hours infusion with classic pump in patients with TM. A total of 54 patients with TM were divided to two groups, first group includes 27 patients (18 female, 9 male) aged between 5.5 and 20.5 years, and were infused a total of 100 mg/kg DFO with infusor in 48 hours. Second group includes 27 patients (18 female, 9 male) aged between 6 and 22 years, were infused a total of 200 mg/kg DFO in 4 days with an intermittent infusions for about in 40 hours. After one year of treatment, the patients were compared from a clinical view point and cost of medical treatment. No statistical difference was found between infusor pump and classic pump in terms of cost-effectiveness.