Peripheral Blood Stem Cell Autografts in Children with Acute Lymphoblastic Leukemia and Lymphoma: Updated Experience

Peripheral blood stem cells (PBSC) in autografts (PBSCT) were given to 16 children with high-risk acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma (NHL). Harvest of PBSC is a safe, reliable procedure with low morbidity in children with cancer, and cryopreserved PBSC are useful in reducing cytopenia following marrow-ablative chemotherapy. The CFU-GM content of the thawed grafts is an important determinant of hematopoietic recovery after PBSCT. Whereas not all collections from children who had received intensive chemotherapy yielded sufficient progenitors for a safe graft, the value of preleukapheresis use of granulocyte colony-stimulating factor to expand the transplantable stem cell pool was not proven. After marrow-ablative chemotherapy without total body irradiation, three children who underwent PBSCT at refractory relapse died within 3 months. However, eight of the remaining 13 children are currently alive and disease-free, 5-29 months after PBSCT.