Optimizing Granulocyte-Colony Stimulating Factor Dosing Scheme in Healthy Stem Cell Donors for Allogenic Transplantation: A Retrospective Cohort Study of Single Dose vs. Split Dose

Objectives The optimal dosing schedule strategy for granulocyte colony-stimulating factor (G-CSF) in healthy stem cell donors remains controversial. This study aimed to compare the efficacy of once-daily versus twice-daily G-CSF administration in allogeneic stem cell donors. Materials and methods We retrospectively analyzed data from 388 healthy unrelated donors (282 males, 106 females) who underwent stem cell mobilization at our center between September 2018 and June 2022. Donors received daily either a single dose of 10 μg/kg/day or two doses of 5 μg/kg/day of filgrastim. Results The split-dose group had significantly higher CD34+ cell counts in peripheral blood (p<0.001), total collected CD34+ cell counts (p<0.001), and total collected CD34+ cell counts per donor body weight (p<0.001) than the single-dose group with one apheresis procedure on the fifth day of GCSF. Multivariable analysis revealed that split-dose G-CSF administration was independently associated with higher peripheral blood CD34+ cell count (p<0.001) and higher total collected CD34+ cell count per donor body weight (p<0.001). Coincidentally, the split-dose group also had higher rates of catheter use (p = 0.003). Conclusion Split-dose G-CSF administration led to better stem cell mobilization than once-daily dosing. These findings contribute to optimizing G-CSF regimens for allogeneic stem cell donation, potentially improving transplantation outcomes.