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Collection of peripheral blood stem cells in pediatric patients: a concise review on technical aspects
P Marson1, M G Petris, G De Silvestro
1Apheresis Service, Blood Bank, University Medical School Hospital of Padova, Italy.
Insights
Collecting peripheral blood stem cells (PBSC) for pediatric cancer patients presents unique challenges. This review addresses technical aspects of pediatric leukapheresis for PBSC collection, optimizing outcomes for children undergoing chemotherapy.
Area of Science:
- Hematology
- Pediatric Oncology
- Transplantation Medicine
Background:
- Peripheral blood stem cells (PBSC) are crucial for hematopoietic support post-chemotherapy in cancer patients.
- PBSC collection in pediatric populations is less documented due to procedural complexities.
- Existing literature lacks comprehensive guidance on pediatric leukapheresis techniques.
Purpose of the Study:
- To review and summarize current knowledge on technical aspects of pediatric leukapheresis for PBSC collection.
- To discuss challenges and solutions for successful PBSC harvesting in children.
- To provide insights into optimizing leukapheresis timing and procedures for pediatric oncology patients.
Main Methods:
- Literature review of pediatric leukapheresis for PBSC collection.
- Analysis of personal experience from 60 procedures in 36 pediatric cancer patients.
- Discussion of technical issues including venous access, extracorporeal circulation volume shifts, and anticoagulation.
Main Results:
- Identified key technical challenges in pediatric leukapheresis: venous access, volume shifts, and anticoagulation risks.
- Highlighted potential severe side effects associated with anticoagulation during the procedure.
- Emphasized the need for careful management of extracorporeal circulation in children.
Conclusions:
- Pediatric leukapheresis for PBSC collection requires specialized technical considerations.
- Optimizing venous access, managing extracorporeal volume, and careful anticoagulation are critical.
- Further research and standardized protocols are needed to improve PBSC collection efficiency and safety in pediatric patients.
Abstract:
Peripheral blood stem cells (PBSC) are now routinely collected for use as hematopoietic support after high-dose chemotherapy for various malignancies. Nevertheless, few data are still available on PBSC collection in pediatric patients, owing to technical problems associated with the leukapheresis procedure in children. This paper briefly summarizes current knowledge about some technical aspects of pediatric leukapheresis for PBSC collection, according to the review of the literature and our personal experience on 60 procedures performed in 36 children affected with various malignancies. Technical issues include venous access, risk of volume shift due to exceeding extracorporeal circulation, and anticoagulation, that can induce severe side-effects. Moreover, criteria for optimizing the PBSC harvesting procedure in children, in particular the correct timing of leukapheresis, are discussed.
