Peripheral Blood Stem Cell Harvesting in Young Children Weighing Less Than 15 Kilograms: A Single-Institute Experience in Taiwan

Abstract

Abstract Autologous peripheral blood stem cell (PBSC) transplantation is crucial in pediatric cancer treatment, and tandem transplantation is beneficial in certain malignancies. Collecting PBSCs in small children with low body weight is challenging. We retrospectively analyzed data of pediatric cancer patients weighing < 15 kg who underwent autologous peripheral blood stem cell (PBSC) transplantation in our institute. Collections were performed in the pediatric intensive care unit over 2 or 3 consecutive days, to harvest sufficient stem cells(goal: ≥2 × 106 CD34 + cells/kg per apheresis). From April 2006 to August 2021, we performed 129 collections after 50 mobilizations in 40 patients, with a median age of 1.9 (range, 0.6–5.6) years and a body weight of 11.0 (range, 6.6–14.7). The median CD34 + cell collection in each apheresis was 4.2 × 106/kg. 78% of mobilizations achieved cell dose for single transplantation, while 56% for tandem transplantation, without additional aliquoting. Age < 2 years, no radiation exposure, and mobilization with chemotherapy were predictors of goal achievement through multivariate analysis (p < 0.05). PBSC collection in 2 or 3 consecutive days is safe and feasible for pediatric patients weighing < 15 kg. Granulocyte colony-stimulating factor alone was not effective for mobilization in children > 2 years, even without radiation exposure.