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[Peripheral blood stem cell collection in pediatric oncohematology. Experience with patients weighing less than 15
P Marson1, M G Petris, C Messina
1Servizio di Immunoematologia e Trasfusionale, Azienda Ospedaliera di Padova.
Insights
Leukapheresis for peripheral blood stem cell collection is safe and effective in children under 15 kg. Careful consideration of pediatric apheresis practices ensures successful outcomes in young cancer patients.
Area of Science:
- Hematology
- Pediatric Oncology
- Apheresis Technology
Context:
- Peripheral blood stem cell (PBSC) collection via leukapheresis is increasingly utilized in pediatric cancer patients.
- Limited data exists on the efficacy and safety of leukapheresis in very young children, specifically those weighing less than 15 kg.
Purpose:
- To evaluate the safety and efficacy of leukapheresis for PBSC collection in pediatric patients weighing less than 15 kg.
- To report the experience of the Padua Apheresis Unit with this specific pediatric population.
Summary:
- A retrospective study analyzed 22 leukapheresis sessions in 15 pediatric patients (under 15 kg) with various malignancies.
- The procedure utilized a Cobe Spectra blood cell separator, with parameters like vascular access, duration, flow rate, and cell yields meticulously recorded.
- No procedure-related complications such as hypotension, hypocalcemia, or hypothermia were observed.
Impact:
- Leukapheresis for PBSC collection is demonstrated to be a safe and effective procedure in pediatric patients weighing less than 15 kg.
- The findings highlight the importance of carefully managing specific aspects of apheresis in children, including vascular access, volume shifts, anticoagulation, and potential side effects.
- This study contributes valuable data for optimizing apheresis protocols in the youngest and smallest patient populations undergoing cancer treatment.
Background:
Leukapheresis for peripheral blood stem cell collection is increasingly being carried out in pediatric cancer patients. Aim of this study was to report experience of the Padua Apheresis Unit on a series of children weighting < 15 kg who have undergone such an apheresis procedure.
Methods:
This retrospective study includes 15 pediatric patients affected with various malignancies (neuroblastoma: 7; acute myelogenous leukemia: 3; rhabdomyosarcoma: 2; PNET: 1; retinoblastoma: 1; Burkitt's lymphoma: 1) collecting peripheral blood stem cells by a Cobe Spectra blood cell separator. Main procedure parameters, including vascular access, leukapheresis duration, blood flow rate, processed blood volumes, side effects, mononuclear and CD34+ cell yields, have been registered.
Results:
Altogether 22 sessions have been carried out, by processing a mean of 2.8 blood volumes. No leukapheresis related complications have been recorded, such as hypotension, hypocalcemia and hypothermia. Noteworthy, in 4 procedures two or more peripheral venipunctures have been performed to ensure an adequate blood flow.
Conclusions:
Leukapheresis for peripheral blood stem cell collection can be safely and efficaciously carried out in pediatric patients, even weighing < 15 kg, on the condition that certain aspects of apheresis practice in children (vascular access, volume shifts, anticoagulation, side effects) are carefully considered.