Abstract

BINI-ANTUNES, Marika et al. Peripheral blood progenitor cells collection in paediatric patients . Arq Med [online]. 2006, vol.20, n.1-2, pp.25-29. ISSN 2183-2447.

Advances in aphaeresis technology allowed the collection of peripheral blood progenitor cell (PBPC) in children candidates to autologous transplantation. We retrospectively analysed clinical and analytical data from 71 children (37 males; 34 females) proposed for autologous PBPC transplantation between 1995 and September 2005. Patients (median age 10 years, range 2-16; median weight 29 kg, range 10-72) presented the following malignancies: neuroblastoma 20, Hodgkin disease 13, acute myeloid leukaemia 9, acute lymphoid leukaemia 8, non-Hodgkin lymphoma 6, Ewing sarcoma 5, others 10. Prior to mobilization, all patients received chemotherapy (median number of 2 protocols, range 1-5) and 9 patients also received radiotherapy. All children were mobilized with G-CSF with a median daily dose of 11,1 µg/kg (range 5-20) in the first mobilization and 18.1 µg/kg (range 6,25-21) in the second mobilization. Collections started on day 5 and a maximum of three aphaeresis per mobilization was performed to obtain at least 2x10⁶/kg CD34+ cells. Twenty children (28,2%) needed a second mobilization and 4 children (5.6%) a third one to achieve the CD34+ cell target. For the aphaeresis collections, red blood cell priming was performed in 32 patients (45%). The median procedure time was 141 minutes and the rate of inlet flow 59 ml/min. We processed a median of 4 blood volumes (range 1.7-4.2) in a single session. A median number of 0,94x10⁶/kg and 0.80x106/kg CD34+ cells was collected per aphaeresis in the first and second mobilization, respectively. The highest CD34+ cell number was obtained in the first day of collection. By linear regression analysis, a significant correlation was observed between peripheral blood CD34+ cell count and CD34+ cells/kg patient body weight collected (Pearson coefficient 0.834, p<0,01). Additionally, a significant correlation between pre-aphaeresis platelet count and CD34+ cell yield and the pre-aphaeresis white blood cell count and CD34+ cell yield was found (Kruskal Wallis test, p<0,01). We didn’t find any correlation between prior radiotherapy and chemotherapy and the number of CD34+ cells collected. Side effects occurred in 46/186 procedures, mainly due to symptomatic hypocalcaemia (n=20) and transient (n=14) or persistent (n=9) catheter occlusion. In summary, PBPC collection in paediatric patients is a safe procedure, with no major complications. Platelet count, white blood cell count and CD34+ cell count pre-aphaeresis were good predictors of CD34+ cell yield.

Keywords : antologous transplantation; children; progenitor stern cell.

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