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Analysis of factors affecting PBPC collection in low-weight children with malignant disorders
J Delgado1, M C Fernandez-Jimenez, A Martinez
1Department of Hematology, Hospital Universitario La Paz, Madrid, Spain.
Insights
Optimizing peripheral blood progenitor cell (PBPC) collection in low-weight children requires considering diagnosis and apheresis volume alongside CD34(+) cell counts. Large-volume leukapheresis (LVL) is a safe and effective method for these pediatric patients.
Area of Science:
- Hematology
- Pediatric Oncology
- Cellular Therapy
Background:
- Peripheral blood progenitor cell (PBPC) collection in children under 25 kg presents challenges.
- These challenges include vascular access, low blood volume, anticoagulation, side effects, and psychological distress.
Purpose of the Study:
- To identify clinical and technical factors influencing PBPC collection in low-weight children.
- To evaluate the impact of apheresis volume and software versions on PBPC yield.
Main Methods:
- Analysis of 88 leukaphereses in 45 children weighing <=25 kg.
- Factors examined included pre-apheresis CD34(+) cell count, COBE Spectra software versions, apheresis volume (standard vs. large-volume leukapheresis - LVL), and patient diagnosis, age, weight, and sex.
Main Results:
- Multivariate analysis revealed that pre-apheresis CD34(+) cell count, patient diagnosis, and apheresis volume independently affected CD34(+) cell yield.
- Large-volume leukapheresis (LVL) was associated with higher CD34(+) cell recruitment.
Conclusions:
- Patient diagnosis and apheresis volume are critical factors for CD34(+) cell yield in pediatric PBPC collection.
- LVL is a safe and effective procedure for children <=25 kg, with mild side effects.
- AutoPBSC software can be reliably used by experienced teams for these pediatric patients.
Background:
PBPC collection in children weighing
Methods:
Data from 88 leukaphereses performed in 45 children were analyzed, including pre-apheresis CD34(+) cell count, COBE Spectra software (version 4.7 versus 6.0), apheresis volume [standard versus large-volume leukapheresis (LVL)] and patient's diagnosis, age, weight and sex.
Results:
The median number of PBPC collected was 6.68 mononuclear cells (MNC)x10(8)/kg (range 2.36-19.05) and 1.69 CD34(+) cellsx10(6)/kg (range 0.08-13.79). Multivariate analysis showed that factors independently associated with the CD34(+) cell yield per apheresis were pre-apheresis CD34(+) cell count (P<0.001), diagnosis (P=0.008) and apheresis volume (P=0.009). Recruitment of CD34(+) cells was also independently affected by the apheresis volume, being higher in the LVL group (P=0.008).
Discussion:
We have demonstrated that, apart from the well-known influence of the pre-apheresis CD34(+) cell count, two other factors have a major impact on the CD34(+) cell yield: patient's diagnosis and apheresis volume. In addition, taking into account that side effects were mild and tolerable, we have confirmed that LVL is a safe and effective procedure in children
