BOB体育

Nosha Farhadfar, MD, and colleagues at University of Florida Health Cancer Center led a study conducted by an international team of researchers using data reported to the Center for International Blood and Marrow Transplant Research. The study led to important, practice-changing discoveries about obese and morbidly obese stem cell donors, which she . Allogeneic stem cell transplant is the only curative option for many patients with leukemia or lymphoma. Obese and morbidly obese individuals make up about 40% of the U.S. population, and this percentage is expected to grow in the near term. Thus, understanding the impact that obesity has on stem cell donation is critical.

In a landmark study that involved over 20,000 unrelated peripheral blood stem cell donors, Farhadfar and colleagues identified an important difference between obese/morbidly obese stem cell donors and donors with a lower body mass index: The stem cell yield is significantly higher among obese/morbidly obese donors. This may be due to the chronic low-grade inflammation present in obese/morbidly obese individuals, leading to an increase in the number of circulating progenitor cells.

Prior to stem cell collection, donors are injected with a medication known as granulocyte colony-stimulating factor to mobilize their stem cells from the bone marrow to the peripheral blood, to increase the yield of stem cell collection. Granulocyte colony-stimulating factor agents are dosed by body weight; thus, heavier donors receive higher doses. However, the researchers observed that increasing the daily granulocyte colony-stimulating factor dose above 780 飦璯/day for obese donors and 900 飦璯/day for morbidly obese donors did not increase stem cell yield. Furthermore, obese/morbidly obese donors were more likely to experience treatment鈥揳ssociated toxicity, including pain, fatigue and insomnia. Farhadfar observes, 鈥淭here is a maximum effective G-CSF dose for peripheral blood stem cell mobilization in obese and morbidly obese donors where higher doses add no additional benefit and may result in more complications.鈥�

These results suggest that weight-based doing of granulocyte colony-stimulating factor is unnecessary for obese/morbidly obese individuals, as higher doses do not improve stem cell yields and contribute to toxicity. Thus, to improve the quality of life of obese/morbidly obese unrelated stem cell donors, 鈥淐onsideration to reduce granulocyte colony-stimulating factor doses in obese and morbidly obese donors should be evaluated to allow for improved donor safety without compromising apheresis efficiency,鈥� says Farhadfar.