ABSTRACT
We retrospectively reviewed the results of transplanting peripheral blood progenitor cell (PBPC) allografts from HLA-matched sibling donors mobilized using various hematopoietic cytokines. Patients had received allografts mobilized with Granulocyte colony-stimulating factor (G-CSF) (G, N = 65) alone, G plus Granulocyte-macrophage colony stimulating factor (GM-CSF) (G/GM, N = 70), or GM-CSF alone at 10 or 15 microg/kg/day (GM, N = 10 at 10 microg/kg/day and 21 at 15 microg/kg/day). The CD34+ and CD3+ cell content of grafts were significantly lower following GM alone compared to G alone (P < 0.001 and 0.04, respectively). Nonhematopoietic toxicity observed in donors precluded dose escalation of GM-CSF beyond 10 microg/kg/day. Hematopoietic recovery was similar among all three groups. Grades II-IV acute graft-versus-host disease (GVHD) was observed in only 13% of patients in the GM alone group compared to 49 and 69% in the G alone or G/GM groups, respectively (P < 0.001). In a multivariate analysis, receipt of PBPC mobilized with GM alone was associated with a lower risk of grades II-IV acute GVHD (hazard ratio 0.21; 95% CI 0.073, 0.58) compared to G alone or G/GM. There were no differences in relapse risk or overall survival among the groups. Donor PBPC grafts mobilized with GM-CSF alone result in prompt hematopoietic engraftment despite lower CD34+ cell doses and may reduce the risk of grades II-IV acute GVHD following HLA-matched PBPC transplantation.
Subject(s)
Graft vs Host Disease/prevention & control , Granulocyte-Macrophage Colony-Stimulating Factor/administration & dosage , Hematopoietic Stem Cell Mobilization/adverse effects , Peripheral Blood Stem Cell Transplantation/adverse effects , Acute Disease , Adolescent , Adult , Aged , Antigens, CD34 , CD3 Complex , Cell Count , Drug Evaluation , Female , Graft Survival , Graft vs Host Disease/etiology , Granulocyte Colony-Stimulating Factor/administration & dosage , Granulocyte Colony-Stimulating Factor/toxicity , Granulocyte-Macrophage Colony-Stimulating Factor/toxicity , Hematopoietic Stem Cell Mobilization/methods , Histocompatibility Testing , Humans , Male , Middle Aged , Peripheral Blood Stem Cell Transplantation/methods , Retrospective Studies , Risk , Siblings , Transplantation, HomologousABSTRACT
A study of 227 elderly participants attending Title III-C nutrition programs was conducted to determine food supplement use and its relationship to nutrition knowledge and quality of the diet. Although nutrition knowledge was found to be positively related to the quality of the diet for all subjects, no significant differences were found between supplement and nonsupplement users for these two variables. Although the mean knowledge score was low, positive relationships were found between nutrition knowledge and both education and income for all subjects. Amount of participation in the government-sponsored nutrition centers was negatively correlated with nutrition knowledge.
