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Mobilization characteristics and strategies to improve hematopoietic progenitor cell mobilization and collection in patients with chronic granulomatous disease and severe combined immunodeficiency.
[severe combined immunodeficiency]
Granulocyte-colony-stimulating
factor
(
G-CSF
)
-
mobilized
autologous
hematopoietic
progenitor
cells
(
HPCs
)
may
be
collected
by
apheresis
of
patients
with
chronic
granulomatous
disease
(
CGD
)
and
severe
combined
immunodeficiency
(
SCID
)
for
use
in
gene
therapy
trials
.
CD
34
+
cell
mobilization
has
not
been
well
characterized
in
such
patients
.
We
retrospectively
evaluated
CD
34
+
cell
mobilization
and
collection
in
73
consecutive
CGD
and
SCID
patients
and
in
99
age-
,
weight-
,
and
G-CSF
dose-matched
healthy
allogeneic
controls
.
In
subjects
aged
not
more
than
20
years
,
Day
 
5
preapheresis
circulating
CD
34
+
counts
were
significantly
lower
in
CGD
and
SCID
patients
than
in
controls
;
mean
peak
CD
34
+
cell
counts
were
58
 
×
 
10
(
6
)
,
64
 
×
 
10
(
6
)
,
and
87
 
×
 
10
(
6
)
/
L
,
respectively
(
p
 
=
 
0
.
01
)
.
The
SCIDs
had
lower
CD
34
+
collection
efficiency
than
CGDs
and
controls
;
mean
efficiencies
were
40
,
63
,
and
57
%
,
respectively
(
p
 
=
 
0
.
003
)
.
In
subjects
aged
more
than
20
years
,
the
CGDs
had
significantly
lower
CD
34
+
cell
mobilization
than
controls
;
mean
peak
CD
34
+
cell
counts
were
41
 
×
 
10
(
6
)
and
113
 
×
 
10
(
6
)
/
L
,
respectively
(
p
 
<
 
0
.
0001
)
.
In
a
multivariate
analysis
,
lower
erythrocyte
sedimentation
rate
(
ESR
)
at
mobilization
was
significantly
correlated
with
better
CD
34
+
cell
mobilization
(
p
 
=
 
0
.
007
)
.
In
SCIDs
,
CD
34
collection
efficiency
was
positively
correlated
with
higher
red
blood
cell
(
RBC
)
indices
(
mean
RBC
volume
,
R
(
2
)
 
=
 
0
.
77
;
mean
corpuscular
hemoglobin
[
Hb
]
,
R
(
2
)
 
=
 
0
.
94
;
mean
corpuscular
Hb
concentration
,
R
(
2
)
 
=
 
0
.
7
;
p
 
<
 
0
.
007
)
but
not
Hb
.
CGD
and
SCID
populations
are
characterized
by
significantly
less
robust
CD
34
+
HPC
mobilization
than
healthy
controls
.
The
presence
of
active
inflammation
or
infection
as
suggested
by
an
elevated
ESR
may
negatively
impact
mobilization
.
Among
SCIDs
,
markedly
reduced
CD
34
collection
efficiencies
were
related
to
iron
deficiency
,
wherein
decreased
RBC
size
and
density
may
impair
apheresis
cell
separation
mechanics
.
Diseases
Validation
Diseases presenting
"severe combined immunodeficiency"
symptom
achondroplasia
alpha-thalassemia
child syndrome
cholangiocarcinoma
junctional epidermolysis bullosa
krabbe disease
omenn syndrome
severe combined immunodeficiency
wiskott-aldrich syndrome
This symptom has already been validated