Peripheral blood stem cell (PBSC) collection in extremely low-weight infants

Bone Marrow Transplant. 1996 Jul;18(1):15-7.

Abstract

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.

MeSH terms

  • Adrenal Gland Neoplasms / drug therapy
  • Adrenal Gland Neoplasms / therapy
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Body Weight
  • Bone Marrow / drug effects
  • Bone Marrow / pathology
  • Cell Count
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Erythrocyte Transfusion
  • Female
  • Graft Survival
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / pharmacology*
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cells / drug effects*
  • Humans
  • Infant*
  • Leukapheresis / instrumentation
  • Leukapheresis / methods*
  • Male
  • Neuroblastoma / drug therapy
  • Neuroblastoma / pathology
  • Neuroblastoma / therapy
  • Platelet Transfusion
  • Vincristine / administration & dosage

Substances

  • Granulocyte Colony-Stimulating Factor
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide

Supplementary concepts

  • CAV protocol