Peripheral blood stem cell apheresis in low-weight children: A single centre study

Area of Science:

• Hematology
• Pediatric Oncology
• Transplantation Medicine

Background:

• Peripheral blood stem cell transplantation (PBSCT) is a standard treatment for hematologic diseases.
• Donors weighing 20 kg or less present unique challenges for PBSCT.
• Optimizing apheresis in pediatric donors is crucial for successful transplantation.

Purpose of the Study:

• To evaluate the efficacy and safety of allogeneic and autologous PBSCT in pediatric donors.
• To assess a modified custom prime method for cell harvesting in this population.
• To determine the feasibility of achieving adequate stem cell yields in children weighing 20 kg or less.

Main Methods:

• Retrospective analysis of demographic and laboratory data from 37 participants (12 autologous, 25 allogeneic).
• Utilized central venous access and a modified custom prime method for apheresis.
• Calculated apheresis details, including CD34+ and CD3 cell counts, and total processed blood volume (TPBV/TBV) ratio.

Main Results:

• 91.9% of individuals achieved the target CD34+ cell dose (2x10^6 cells/kg) in one apheresis session.
• The mean harvested CD34+ cell counts were 5.28x10^6/kg (allogeneic) and 3.57x10^6/kg (autologous).
• Median engraftment for white blood cells was 14 days (allogeneic) and 13 days (autologous); platelet engraftment was 19.5 days for both.

Conclusions:

• The modified custom prime method is effective for stem cell harvesting in pediatric donors under 20 kg.
• Successful allogeneic and autologous PBSCT can be achieved in this challenging donor group.
• The procedure was performed without complications during leukapheresis, demonstrating its safety.