Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2008, Vol. 04 ›› Issue (06): 555 -562. doi: 10.3877/cma.j.issn.1673-5250.2008.06.110

Original Article

Large Volume Leukapheresis for Peripheral Blood Stem Cell Collection in Children

Hong-gui XU, Yang LI, Yan XIA, Jie-yun LIANG, Shao-liang HUANG, Jian-pei FANG   

  1. Department of Pediatrics, the Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510120, China
  • Published:2008-12-01
Objective

To summarize the experiment of large-volume leukapheresis(LVLs)for peripheral blood stem cell(PBSC)collection in children by blood cell separator to investigate the efficacy and variability of peripheral blood stem cell harvests.

Methods

Seventy-six large-volume leukapheresis were performed using CS 3000 plus cell separator with SVCH separation clip and special program in 40 patients(donors)whose median age and body weight were 8 years(range 2~18)and 22 kg(range 9. 0~45). The number of mononuclear cell(MNC)and CD34+ cell collected, the collection efficiency(CE)of mononuclear cell components and electrolyte in peripheral blood, and adverse events were recorded and analyzed.

Results

In 76 peripheral blood stem cell collection procedures, the time performed was only once in five receivers, third times in one receiver and the twice in the others. A median of 3. 5(3. 0~4. 5)times of blood volume was processed per session. The median collection efficiency of mononuclear cell was 45. 2%(range 30. 0%~112. 0%). The median cell collected of mononuclear cell and CD34+ was 2. 5(1. 2~6. 5)× 108/kg and 3. 5(2. 7~14. 9)× 106/kg, and a significant correlation was shown between them. On univariate analysis, variables that positively influenced collection of mononuclear cell yield were the processed blood volume(r=0. 45, P<0. 05), peripheral blood leukocytes(r=0. 60, P<0. 05), mononuclear cell peripheresis(r=0. 68, P<0. 05)and CD34+ cell peripheresis(r=0. 75, P<0. 05), respectively. The hemoglobin(Hb)and platelet(PLT)count in the peripheral blood decreased after apheresis, especially after the second time apheresis(P<0. 05). But little change was observed in Serum electrolyte level. A total of 14(18. 4%)adverse events and 67(88. 2%)technical problems out of 76 procedures were recorded, and large-volume leukapheresis was well tolerated by all children.

Conclusion

These data suggested that large-volume leukapheresis was safely and effectively applied to children, even those with low body weight, to collect adequate peripheral blood stem cell for transplantation. Improved mononuclear cell yield could be achieved by increasing blood volume and G-CSF pre-treatment.

图1 台盼蓝染色测定细胞活性
图2 FACS检测CD34+细胞数量
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