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Large-volume leukapheresis for peripheral blood stem cell collection in children: a simplified single-apheresis
1Haematology Department, Hospital Universitario de la Princesa, Madrid, Spain.
Insights
Large volume leukapheresis (LVL) is a safe and effective method for collecting peripheral blood stem cells (PBSC) in children with cancer. This procedure allows for adequate cell collection in most cases, ensuring successful transplantation and engraftment.
Area of Science:
- Pediatric Hematology Oncology
- Stem Cell Transplantation
- Leukapheresis Procedures
Background:
- Peripheral blood stem cell (PBSC) collection is crucial for pediatric cancer transplantation.
- Large volume leukapheresis (LVL) is a technique for processing large blood volumes for cell collection.
Purpose of the Study:
- To evaluate the safety and efficacy of LVL for PBSC collection in pediatric patients.
- To determine the adequacy of cell yield and engraftment success following LVL.
Main Methods:
- LVL was performed in 27 pediatric patients (1-15 years) with various malignancies.
- Granulocyte-colony stimulating factor (G-CSF) was administered for 4 days prior to apheresis.
- Cell counts (MNC, CD34+, CFU-GM) were analyzed, and engraftment was monitored post-transplant.
Main Results:
- 92.5% of patients required only a single apheresis session for adequate PBSC yield.
- LVL was well-tolerated with no consistent side-effects observed in pediatric patients.
- All 19 transplanted patients achieved sustained engraftment after myeloablative treatment.
Conclusions:
- LVL is a safe, effective, and easily performed procedure for pediatric PBSC collection.
- Adequate stem cell yields are achievable with LVL, supporting successful transplantation outcomes.
- Prompt hematological engraftment is consistently achieved in children undergoing LVL and transplantation.
Abstract:
Large volume leukapheresis (LVL) defined as the processing of greater than three volumes of blood in a single session for peripheral blood stem cell (PBSC) collection was performed in 27 children, aged from 1 to 15 years, with various malignancies. Harvesting of PBSC was started after 4 days of cytokine (G-CSF 12 micrograms/kg s.c.) alone. With the exception of two cases the rest (92.5%) needed only a single apheresis to yield the minimum number of cells required for transplantation. No consistent side-effects were observed and the LVL were well tolerated by children. An average of 7.6 x 10(8) MNC/kg, 6.1 x 10(6)/kg CD34+ and 2.1 x 10(4)/kg CFU-GM were harvested. To date, 19 patients have been transplanted after myeloablative treatment and sustained engraftment was achieved in all cases. LVL can be safely and easily performed in children allowing adequate PBSC collection for transplantation with prompt hematological engraftment.