Peripheral blood stem cell (PBSC) collection in extremely low-weight infants.
While PBSC collection has become a safe procedure for adults, only a few reports exist about its efficacy, safety and feasibility in paediatric patients, especially extremely low-weight infants. We describe successful PBSC collection in three infants of less than 10 kg body weight (BW; range: 6.92-9.4 kg) suffering from stage IV neuroblastoma. Harvest of PBSC started after mobilisation with high-dose chemotherapy and G-CSF, as soon as 1.0% CD34+ cells were detected. Collections were performed using a Baxter CS-3000 Plus separator primed with a mixture of irradiated, white cell-depleted and CMV-negative packed red cells resuspended in 5% human albumin and diluted with saline to match the patient's haematocrit. Performing a median of four, (4-7, median, range) procedures we collected at least 4 x 10(8)/kg BW nucleated cells (NC) from all three patients. The infants were not sedated and showed no serious side-effects. All three children were successfully transplanted with myeloid engraftment in 8 (7-9) days, independence from red cell support was achieved in 15 (10-20) days and from platelet transfusions in 25 (14-29) days after PBSC infusion. We conclude that PBSC harvesting using continuous flow cell separators is safe, even in low-weight infants of less than 7 kg BW.
Nussbaumer
W
W
Department of Transfusion Medicine, University Hospital, Innsbruck, Austria.
Schönitzer
D
D
Trieb
T
T
Fink
F M
FM
Maurer-Dengg
K
K
Höcker
P
P
Wagner
A
A
Schwaighofer
H
H
Nachbaur
D
D
Niederwieser
D
D
D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology* / Q000627:therapeutic use; D001835:Body Weight; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology; D002452:Cell Count; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D017707:Erythrocyte Transfusion; D005260:Female; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007937:Leukapheresis / Q000295:instrumentation / Q000379:methods*; D008297:Male; D009447:Neuroblastoma / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D017713:Platelet Transfusion; D014750:Vincristine / Q000008:administration & dosage
D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide