Reflections on methodical approaches to hematopoietic stem cell collection in children

Area of Science:

• Pediatric Hematology
• Apheresis Medicine
• Cellular Therapy

Background:

• Pediatric peripheral blood stem cell collection (PBSC) is complex due to children's smaller body mass and physiology.
• Challenges include extracorporeal volume, venous access, and citrate toxicity, particularly in very low body weight (BW) children (<20kg).

Purpose of the Study:

• To address the lack of standardized practices in pediatric PBSC collection.
• To propose evidence-based recommendations for safe and efficient procedures.

Main Methods:

• Review of current challenges and best practices in pediatric apheresis.
• Synthesis of information to form practical recommendations for clinical teams.

Main Results:

• Identification of key challenges: extracorporeal volume, venous access, citrate toxicity.
• Emphasis on the critical role of an experienced multidisciplinary team (pediatricians, apheresis specialists, nurses, CVC providers).

Conclusions:

• Standardized, evidence-based guidelines are needed for pediatric PBSC collection.
• Recommendations will support teams with limited experience, improving patient safety and collection efficiency.