Hematopoietic progenitor cells collection in pediatric patients with brain tumor

To analyze the efficacy and safety of hematopoietic progenitor cells (HPC) collections by leukapheresis in pediatric patients with brain tumors.

Between 2003 and 2014, we collected HPC from 19 children (12 boys/7 girls), median age at the diagnosis of 5 years old (<1-15 years old) and weight of 16.8 Kg (6.7-42). Diagnoses were Medulloblastoma (n = 10), Primitive Neuroectodermal Tumor (n = 5), Atypical Teratoid Rhabdoid Tumor (n = 3) and Secreting Germ Cell Tumor (n = 1). All patients performed leukapheresis by a central venous catheter, at the fifth day of mobilization with G-CSF (median dose 11.7 µg/Kg/day), 9 of them with COBE® Spectra and 10 with Spectra Optia®. The anticoagulant used was ACD-A, ratio of 14:1 or ACD-A plus heparin, ratio 25:1. The tubing set was primed with a compatible, irradiated, leukodepleted and hematocrit adjusted packed red cells for all children <30 kg (n = 17). A median of 1.5 (1-3) leukapheresis per patient was performed with an average of 3 (1.5-5.4) blood volumes processed; 3 children did a second mobilization and one additional leukapheresis. The median number of CD34+ cells collected was 4.6 × 10(6) /Kg (0.18-22.6) of patient body weight; 12 children collected for a tandem transplant. The median time between cell collection and infusion was 3 (0.6-9.1) months.

HPC collection in children is an efficient and well tolerated technique, performed as an outpatient procedure. With the new mobilization schemes and leukapheresis technology, we can collect a high number of HPC allowing pediatric oncologist to establish more aggressive chemotherapy protocols hoping to improve patient outcome.