title: Peripheral blood stem cell collection in pediatric patients: feasibility of leukapheresis under anesthesia in uncompliant small children with solid tumors.
abstract: Leukapheresis demands patient's compliance and adequate vascular accesses, which can require invasive methods in very small children whose treatment protocol includes hemopoietic stem cell collection for myeloablative chemotherapy and stem cell rescue. Since 1998, at the Istituto Nazionale Tumori of Milan, in selected uncompliant small children, the placement of peripheral vascular accesses and leukapheresis have been performed at the same time under general anesthesia. Peripheral venous cannulas were positioned for blood collection, while blood was returned through either peripheral cannulas or mono-lumen central catheters previously installed for chemotherapy. A continuous-flow cell separator was used for leukapheresis. Between 1998 and 2003, 47 children with solid tumors underwent anesthesia for a total of 54 leukaphereses. The patients' age ranged from 12.7 to 93 months (median 30.3) and their weight ranged from 7 to 20 kg (median 14.1). Neither metabolic nor anesthesiological complications were recorded. In 89% of cases, the CD 34(+) cell target was achieved at a single harvest; the median number of CD 34(+) cells was 10.8 x 10(6)/kg/leukapheresis (range 1-117) and the median collection efficiency was 63.4% (range 25-100.6). Leukapheresis under anesthesia is feasible and safe in very low-weight children whose compliance is lacking due to age and disease.
authors: Immunohematology and Transfusion Medicine Service, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
authors: Fernando
authors: F
authors: Ravagnani
authors: Paola
authors: P
authors: Coluccia
authors: Paola
authors: P
authors: Notti
authors: Flavio
authors: F
authors: Arienti
authors: Alvaro
authors: A
authors: Bompadre
authors: Mario
authors: M
authors: Avella
authors: Fabio
authors: F
authors: Bozzi
authors: Elena
authors: E
authors: Barzanò
authors: Marta
authors: M
authors: Podda
authors: Sandro
authors: S
authors: Pupa
authors: Roberto
authors: R
authors: Luksch
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D018952:Antigens, CD34; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D007937:Leukapheresis / Q000379:methods* / Q000592:standards; D007958:Leukocyte Count; D009369:Neoplasms / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D016312:Treatment Refusal
chemical_list: D018952:Antigens, CD34