Allogeneic peripheral blood stem cell transplant in children

Area of Science:

• Hematology
• Pediatric Oncology
• Stem Cell Transplantation

Background:

• Allogeneic peripheral blood stem cell (PBSC) transplant is a recognized treatment for hematological malignancies.
• Existing data primarily focuses on adult patients, leaving a gap in knowledge regarding pediatric applications.
• Assessing the safety and feasibility in children is crucial for expanding treatment options.

Purpose of the Study:

• To evaluate the safety and feasibility of allogeneic PBSC transplantation in pediatric patients.
• To assess the outcomes of pediatric donors undergoing stem cell mobilization and apheresis.
• To determine the incidence of graft-versus-host disease (GVHD) and long-term remission rates.

Main Methods:

• Eleven pediatric patients (aged 2-16 years) with various hematological malignancies received allogeneic PBSC transplants.
• Donors included HLA-identical siblings and one-antigen mismatched family members, with eight donors being pediatric.
• Donors received G-CSF for mobilization; apheresis was performed, and cell doses were quantified.

Main Results:

• All patients achieved neutrophil engraftment by a median of 16 days and platelet engraftment by a median of 13 days.
• Only one patient experienced Grade II acute GVHD; chronic GVHD was not observed in patients with >3 months follow-up.
• Eight patients achieved continuous complete remission, ranging from 2 to 26 months post-transplant.

Conclusions:

• Allogeneic PBSC transplantation is a safe and feasible procedure for pediatric patients with hematological malignancies.
• The procedure in pediatric donors appears safe and effective.
• Allogeneic PBSC transplant in this cohort did not show an increased incidence of acute or chronic GVHD.