Young child as a donor of cells for transplantation and lymphocyte based therapies
1Department of Pediatric Hematology and Oncology, Nicolaus Copernicus University Torun, Jurasz University Hospital, Collegium Medicum, ul. Curie-Sklodowskiej 9, 85-094, Bydgoszcz, Poland.
Insights
Collecting hematopoietic stem cells (HSCs) from pediatric sibling donors via bone marrow or peripheral blood is safe. While mild side effects can occur, severe adverse events are rare in children undergoing HSC collection.
Area of Science:
- Pediatric Hematology
- Transplantation Immunology
- Cellular Therapy
Background:
- Hematopoietic cell transplantation (HSCT) in children often prioritizes bone marrow (BM) for hematopoietic stem cell (HSC) collection.
- Pediatric sibling donors are a crucial source of HSCs for HSCT.
Purpose of the Study:
- To evaluate the safety and feasibility of peripheral blood HSC (PBSC) collection in pediatric sibling donors.
- To compare adverse events associated with BM harvest versus PBSC collection in pediatric donors.
Main Methods:
- Review of safety data for BM harvest and PBSC collection in pediatric sibling donors.
- Analysis of adverse events, including severe adverse events (SAE) and early adverse effects (AE).
- Assessment of G-CSF administration for PBSC mobilization in pediatric donors.
Main Results:
- Both BM and PBSC collection are safe in pediatric sibling donors, with achievable HSC yields from PBSC.
- The risk of SAE is lower in pediatric donors compared to adults.
- Early AEs are generally mild and manageable, though PBSC collection in children under 20 kg may carry specific risks.
- Short-term G-CSF administration for PBSC collection is considered safe in pediatric donors.
Conclusions:
- PBSC collection is a safe alternative to BM harvest for pediatric sibling donors.
- Informed consent regarding potential complications is essential for pediatric donors and their families.
- Further research is needed on the long-term effects of G-CSF in pediatric donors.
Abstract:
In most cases of hematopoietic cell transplantation (HSCT) in pediatric recipient, the priority is given to bone marrow as a hematopoietic cell (HSC) source. The same expectations should be given to pediatric sibling donor. Bone marrow (BM) harvest is a standard method of HSC collection in pediatric siblings, however peripheral blood HSC (PBSC) collection is safe in healthy pediatric donors, and target hematopoietic cell yields can be achieved. Bone marrow or peripheral blood cell collection, both hematopoietic cells and lymphocytes, in pediatric sibling donors is safe, however there is a small risk of severe adverse events (SAE); still the risk of SAE is lower in children than in adults. The early adverse effects (AE) both after BM and PBSC collection are mild, short-term and easy to prevent or control, however they can occur in a relatively large proportion of donors. The risk of mild AE is lower in children than in adults, except PBSC collection in children <20 kg, who might be at risk of various complications. Short-term G-CSF administration and PBSC collection in pediatric donors is safe. No data exist on long-term adverse effects of short-term G-CSF course. Pediatric donors and their parents must be informed about the risk of possible complications.
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