Stem cell procurement and transplantation in paediatric patients

Area of Science:

• Hematology
• Pediatric Oncology
• Cellular Therapy

Background:

• Peripheral blood stem cell (PBSC) harvesting via apheresis is a standard procedure.
• Challenges exist in pediatric PBSC collection due to small blood volumes, leading to protein loss and red cell trapping.
• Priming cell separators with albumin or red blood cells is crucial for patients with <1500 mL blood volume.

Purpose of the Study:

• To evaluate the safety and efficacy of PBSC harvesting in young children.
• To determine the feasibility of apheresis in pediatric patients with malignancies.
• To establish optimal PBSC collection targets for successful engraftment.

Main Methods:

• PBSC apheresis was performed using cell separators in pediatric patients.
• Priming protocols were adapted for children with low blood volumes.
• Collection efficiency and engraftment success were monitored post-chemotherapy.

Main Results:

• Ten children (0.8-5 years) underwent successful PBSC apheresis without major complications.
• Forty-one pediatric patients underwent 189 apheresis procedures for various malignancies.
• An average of 3.7 x 10^4/kg CFU-GM was collected per child.
• Engraftment was sustained with >3 x 10^4/kg reinfused PBSCs.
• 5/25 patients achieved long-term complete remission.

Conclusions:

• PBSC harvesting is a safe and effective procedure in young children, even with low blood volumes.
• Optimized apheresis protocols facilitate successful stem cell collection for pediatric cancer treatment.
• Adequate PBSC dosage is critical for achieving sustained engraftment and long-term remission in pediatric malignancies.