Technique for PBSC harvesting in children of weight under 10 kg.
Peripheral blood stem cell (PBSC) harvesting in the smallest children (weight <10 kg) using separators is complicated by specific problems. The volume of the separation set exceeds 25% of the total blood volume and the vascular access is generally not sufficient. Therefore, a simple manual technique for PBSC harvesting was developed. Three children (6-9 kg), with newly diagnosed tumours were scheduled to be treated with three to six sequential courses of high-dose chemotherapy, each followed by PBSC support. PBSC harvests were started after mobilization using cyclophosphamide and G-CSF when the peripheral blood CD34+ cell count exceeded 50/microl. About 50 ml of blood was drawn from a venous catheter, injected into a transfer bag containing ACD-A, and centrifuged. The buffy coat obtained was pooled in a collection bag, remaining plasma and erythrocytes were immediately reinfused and a subsequent cycle started. From three to 13 cycles were performed in 1-3 days and 18.0-32.2 x 10(6) CD34+cells/kg were collected. We did not detect any bacterial contamination or any notable complications. Fifteen PBSC reinfusions have been performed to date, each with rapid engraftment taking between 7 and 13 days. Patients are in very good PR (18 months from diagnosis) or in CR (6 and 8 months). We can conclude that this procedure is feasible and safe.
Korístek
Z
Z
Department of Internal Medicine - Hematooncology, Masaryk University Hospital, Brno, Czech Republic.
Sterba
J
J
Havranová
D
D
Mayer
J
J
D018952:Antigens, CD34 / Q000032:analysis; D001781:Blood Component Removal / Q000379:methods*; D001800:Blood Specimen Collection / Q000379:methods; D001835:Body Weight; D002648:Child; D015925:Cryopreservation; D006085:Graft Survival; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods / Q000592:standards; D006412:Hematopoietic Stem Cells; D006801:Humans; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods / Q000592:standards; D012509:Sarcoma / Q000628:therapy; D014182:Transplantation, Autologous / Q000379:methods / Q000592:standards
D018952:Antigens, CD34