Safe and Efficient Peripheral Blood Stem Cell Collection in the Smallest of Children

Abstract

To clarify the factors that may affect the peripheral blood stem cell (PBSC) collection in children weighing < or = 15 kg, a consecutive registry of 109 leukapheresis procedures was analyzed. Collections were performed on a COBE Spectra separator. In 65.1% of the procedures, the peripheral vein, together with a central catheter inserted routinely at diagnosis, or 2 peripheral veins were used to access/return. For 84.4% of the procedures, the extracorporeal line was primed with red blood cells. The median granulocyte-macrophage colony forming unit (CFU-GM) number derived from 1 patient's blood volume processed was 13.8 x 10(4)/kg. Six times, a collection series failed, always in children treated for > or = 26 weeks and 4 of those times in children weighing < or = 11 kg. The patient's age, diagnosis, duration of preleukapheresis treatment, and mobilization regimens did not significantly affect the collection yield. Twenty-four transplantations were performed. The median times to neutrophils >0.5 x 10(9)/L and platelets >20 x 10(9)/L were 13 and 20 days, respectively. We conclude that even in very small children, leukapheresis can be performed safely, allowing adequate PBSC collection for transplantation and/or in vitro manipulations.