RESUMO
Concentration of bone marrow aspirates is an important prerequisite prior to infusion of ABO incompatible allogeneic marrow and prior to cryopreservation and storage of autologous marrow. In this paper we present our experience in processing 15 harvested bone marrow for ABO incompatible allogeneic and autologous bone marrow (BM) transplantation using Cobe Spectra® cell separator. BM processing resulted in the median recovery of 91.5% CD34+ cells, erythrocyte depletion of 91% and volume reduction of 81%. BM processing using cell separator is safe and effective technique providing high rate of erythrocyte depletion and volume reduction, and acceptable recovery of the CD34+ cells.
Assuntos
Transplante de Medula Óssea/métodos , Medula Óssea/metabolismo , Separação Celular/instrumentação , Separação Celular/métodos , Sistema ABO de Grupos Sanguíneos , Adolescente , Anemia Aplástica/terapia , Antígenos CD34/metabolismo , Incompatibilidade de Grupos Sanguíneos , Medula Óssea/patologia , Células da Medula Óssea/citologia , Criança , Pré-Escolar , Eritrócitos/citologia , Feminino , Humanos , Lactente , Leucemia Mieloide Aguda/terapia , Linfo-Histiocitose Hemofagocítica/terapia , Linfoma não Hodgkin/terapia , Masculino , Síndromes Mielodisplásicas/terapia , Neuroblastoma/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapiaRESUMO
Survival of patients with high-risk pediatric solid tumors has improved with the introduction of a high-dose chemotherapy regimen and autologous stem cell rescue. Here, we present our data regarding the evaluation of the efficacy and safety of hematopoietic stem cell mobilization and harvesting in children with solid tumors. From November 2002 to March 2010, 85 children underwent autologous peripheral blood stem cell collection; 35 (41.1%) of them weighed less than 20 kg and were diagnosed with neuroblastoma, Wilms' tumor, medulloblastoma, yolk sac sarcoma, or non-Hodgkin's lymphoma. The mobilization regimens included disease-specific chemotherapy plus granulocyte colony-stimulating factor in most of the patients. The median age and weight at the time of apheresis was 36 months and 13.5 kg, respectively. Large-volume leukapheresis was performed with the aim of reducing the psychological and financial impact of leukapheresis by reducing the number of procedures while collecting a large number of cells. The median number of mobilization and leukapheresis procedures per case was one. The pre-apheresis CD34+ cell count ranged from 2 to 845 µL, with a median of 24 µL. A median of four patient blood volumes was processed per procedure, lasting 279 min (range, 113-420 min). A radial catheter was used for harvesting in 35 procedures (71.4%). The median yield of CD34+ cells was 6.6×10(6) /kg per patient. The targeted dose of 5×10(6) /kg CD34+ cells was realized in 80% of patients. The tolerance of peripheral blood stem cell collection in our patients was good. In conclusion, the collection of peripheral blood stem cells is an effective and safe procedure, even when conducted on the youngest children.