This study will determine whether the spleen in people who donate stem cells (bone marrow
cells collected from the blood) enlarges as a result of taking granulocyte
colony-stimulating factor (G-CSF). Donors take this growth factor to maximize the amount of
stem cells that can be collected for transplantation to patients with leukemia or other
diseases. The study will also examine whether changes in the donor's white blood cell
count, blood stem cell count, and blood chemistries can predict a change in spleen size.
Stem cells donors take G-CSF for 5 to 6 days before donating. Besides increasing the number
of stem cells and white blood cells in the bloodstream, the drug also causes some other
temporary changes in blood chemistry. Many people who take G-CSF for a few days get a
headache, feel an ache in their bones, or feel tired for a few days. About one-third of
patients chronically treated with G-CSF to raise blood cell counts develop an enlarged
spleen. It is not known if a brief 5- to 6-day course of G-CSF also affects the size of the
spleen, but about 1 in 10,000 blood stem cell donors have had a spontaneous rupture of the
Adults and children 18 years of age and older who are donating stem cells for relatives
enrolled in clinical trials at the National Institutes of Health may participate in this
study. They will donate stem cells according to the standard procedure, but will give an
extra 15 milliliters (3 teaspoons) of blood both before receiving G-CSF and after donating
stem cells. Donors' spleen size will be measured by ultrasound scanning of the abdomen
three times: the day before receiving G-CSF, the day after donating the stem cells and 4
days after donating.
The administration of granulocyte-colony stimulating factor (G-CSF) leads to splenic
enlargement in approximately one third of neutropenic patients who are chronically treated
with this drug. Short courses, 5 to 6-days, of G-CSF are used to increase the yield of
hematopoietic progenitor cells collected by apheresis from peripheral blood stem cell (PBSC)
donors. G-CSF mobilized PBSC concentrates are increasingly replacing marrow as a source of
hematopoietic progenitor cells for transplants involving HLA-compatible relatives. PBSC
donors experience splenomegaly and rarely, spontaneous rupture of the spleen. Since
splenomegaly is a risk factor for splenic rupture, it is important to determine the
incidence and time course of splenic enlargement in PBSC concentrate donors. This protocol
will prospectively study 40 subjects donating G-CSF mobilized PBSC for HLA compatible
relatives or donating PBSC's for laboratory investigations at the Department of Transfusion
Medicine in the Warren G. Magnuson Clinical Center. The subjects will be given G-CSF for 5
days and a PBSC concentrate will be collected on day 5. Ultrasound scans will be used to
assess their spleen size. The scans will be performed before G-CSF administration and the
day the last PBSC concentrate is collected. A third scan will be performed 10 or 11 days
after the last PBSC is collected. The effects of several parameters on spleen size will be
assessed including: donor age, gender, race and changes in liver function assays, white
blood cell counts, platelet counts, and CD34+ cell counts.
Adults and children 18 years of age or greater will be studied.
Enrolled in a primary stem cell transplant protocol that has been approved by the IRB.
Potential subjects are people donating PBSC concentrates for HLA-compatible relatives as
part of IRB approved protocols or donating PBSCs for laboratory investigations.
Donors who cannot remain in the Bethesda area for an additional 4 to 5 days following
their donations will be excluded from the third ultrasound.