Naslov
Autologous peripheral blood steam cell collection in small children and adolescents: side effects and safety issues

Autori
Bojanić, Ines ; Golubić Ćepulić, Branka ; Lukić, Marija ; Plenković, Fini ; Ivanković, Zdravko ; Raijć, Ljubica ; Jakovljević, Gordana ; Batinić, Drago ; Nemet, Damir ; Labar, Boris

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Skup
15th ISBT European Regional Conference

Mjesto i datum
Atena, Grčka, 2.-7.6

Vrsta sudjelovanja
Poster

Vrsta recenzije
Podatak o recenziji nije dostupan

Ključne riječi
autologous peripheral blood steam cell collection, small children, adolescents, side effects, safety issues

Sažetak
Aims:Autologous peripheral blood stem cells (PBSC) are increas-ingly used for transplantation instead of bone marrow, even in smallchildren and adolescents. We reviewed the incidence and nature ofadverse events during PBSC donation in pediatric patients withhematological malignancies and solid tumors.Method:Weanalyzed 66 autologous apheresis procedures per-formed in 23 children (39.1% males, 60.9% females) who weremobilized using chemotherapy and/or hematopoietic growthfactors. Eight patients suffered from lymphoma, 7 from neuroblas-toma, 6 from acute leukaemia, 1 from Ewing sarcoma and 1 fromganglioneuroblastoma. The median age was 15 years (range 3–18)and the median body weight 51 kg (range 16–67). All patientsneeded a double-lumen central venous catheter: 10 subclavian, 2jugular and 11 femoral vein catheters. The apheresis procedureswere carried out with continuous flow blood cell separator COBESpectra and all patients underwent large volume leukapheresis(LVL). In all procedures, a blood warmer was connected to the returnline and a continuous calcium infusion was administered preven-tively. Six patients, who were under 25 kg body weight, had theextracorporeal circuit primed with irradiated, filtered packed redcells diluted with 5% albumin solution. Seven children had vitalsigns and ECG continuously monitored during the procedure.Results:Each patient underwent a median of 2 collections (range1–6). The inlet blood flow ranged between 16.0 and 95.4 mL/min(median 54.5 mL/min). The median blood volume processed was 11754 ml (range 2700–22 500). Leukapheresis lasted a median of 240 min (range 120–270). The median total nucleated cell yield was11.86 ¥10E8/kg (range 1.94–21.21), mononuclear cell (MNC) yieldwas 6.01 ¥10E8/kg (range 0.97–12.73) and CD34+cell yield was3.5 ¥10E6/kg (range 0.19–28.01). The median of MNC collectionefficiencies was 56.11% (range 12.34–158.09). In 9 (39.1%) patients, in only one apheresis procedure more than 2 ¥10E6 CD34+cell/kgwere collected. During 6 (9.09%) procedures patients had experi-enced apheresis-related side effects. The citrate- induced reactionswere most commonly observed. The reactions were mild and ces-sation of collection was required only in one case, because ofcatheter related complication. Mild sedation was required only infew very small children. Post-donation platelet count was less than30 ¥10E9/L in 3 cases and these patients required platelet trans-fusion before subsequent procedure.Conclusion:Our results show that LVL in pediatric patients is rel-atively safe procedure, well tolerated and with a very low risk ofserious adverse events. Close monitoring of blood counts, especiallyplatelets, between PBSC collections is necessary. The cessation ofprocedure was required in only one case and no life threateningside effects occurred.

Izvorni jezik
Engleski

Znanstvena područja
Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

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