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Optimizing pediatric peripheral blood stem cell collection.
Nidhi Sharma1, Rajesh B Sawant1, Santanu Sen2
1Transfusion Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.
Summary
Pediatric peripheral blood stem cell (PBSC) collection is safe, with successful harvests linked to higher pre-procedure CD34+ counts and allogeneic donation. Identifying factors influencing collection success is key for optimizing pediatric stem cell transplantation.
Area of Science:
- Hematology
- Pediatric Oncology
- Transplantation Medicine
Background:
- Pediatric peripheral blood stem cell (PBSC) harvests present unique apheresis challenges.
- Understanding variables affecting PBSC collection is crucial for planning pediatric procedures.
Purpose of the Study:
- To analyze the safety profile of pediatric PBSC procedures.
- To identify variables influencing successful PBSC collection in children.
Main Methods:
- Retrospective review of 85 pediatric PBSC harvest procedures over 3 years.
- Analysis of donor, procedural, and product parameters.
- Definition of successful collection: CD34 dose ≥ 2 × 10^6 cells/Kg recipient body weight.
Main Results:
- Successful collection achieved in 61.17% of procedures.
- Key factors for success included pre-procedure CD34+ count (>19.7/μL), monocyte count (>1.65 × 10^6/μL), allogeneic collection, and female gender.
- A single systemic adverse reaction (0.01%) was managed conservatively.
Conclusions:
- PBSC collection is a safe procedure in pediatric populations.
- Pre-procedure CD34+ counts ≥ 20/μL may predict successful stem cell dose collection.
- Identifying factors for failed collections aids in patient counseling and justifies the use of stem cell mobilizing agents.
