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. 2020 Sep;35(5):406-412.
doi: 10.1002/jca.21813. Epub 2020 Jul 25.

An alternative procedure to leukapheresis for peripheral hematopoietic progenitor cell collection in very-low-weight children: A single pediatric center experience

Valentina Becherucci  1 , Stefano Ermini  2 , Luisa Piccini  1 , Silvia Bisin  1 , Valentina Gori  1 , Francesca Gentile  1 , Riccardo Ceccantini  1 , Elena De Rienzo  1 , Barbara Bindi  1 , Paola Pavan  1 , Vanessa Cunial  1 , Elisa Allegro  2 , Francesca Brugnolo  1 , Daniela Maggio  2 , Daniela Calzolari  2 , Erika Maccarelli  2 , Silvia Galli  2 , Sonia Muricci  2 , Marco Berchielli  2 , Veronica Tintori  3 , Iacopo Sardi  4 , Franco Bambi  1
Affiliations

An alternative procedure to leukapheresis for peripheral hematopoietic progenitor cell collection in very-low-weight children: A single pediatric center experience

Valentina Becherucci et al. J Clin Apher. 2020 Sep.

Abstract

Background: PBSC collection using a blood cell separator in very low weight patients can be frequently complicated by severe adverse effects and technical difficulties.

Material and methods: From March 2013 to January 2017, 14 PBSC collections were performed in 12 children weighing less than 10 kg, affected by different solid tumours. PBSC collection was performed with a "homemade" aseptically assembled circuit. The circuit is composed by a 150 mL collection bag connected with a 4 stopcock ramp, perfused with ACD. This circuit allows collection of a specific total blood amount from CVC, depending on CD34+ /kg target.

Results: Mean CD34+ cell performance per collection was 9.3 × 106 /kg. Tolerance to the procedure was very good as none of the patients experienced complications, with the exception of a patient who showed mild cyanosis and pallor after collection. Moreover, no bleeding or thrombotic complications have been observed. To date, 16 PBSC reinfusions have been performed in 7 children with a mean CD34+ cells viability of 98.1% ± 2.7 and mean WBC viability of 57% ± 10. Cell recovery after thawing was 87% ± 10.8. A rapid graft intake for both neutrophils and platelets, between day 7 and 20 after reinfusion was observed.

Discussion: The procedure of total blood collection without the use of a cell separator is feasible and allows a good PBSC collection without significant side effects in very low-weight children. Moreover, this method could represent a valid and safe alternative to leukapheresis in patients where classic procedure could be difficult to apply.

Keywords: CD34; autologous transplantation; bloodletting procedure; infants; leukapheresis procedure; peripheral blood stem cell collection.

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References

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