METHODS: The data of pediatric patients who underwent autologous stem cell mobilization and apheresis between January 2011 and April 2020 were analyzed retrospectively.
RESULTS: We studied retrospectively 64 mobilization and apheresis procedures in 48 pediatric patients (34 males, 14 females), mean age of 7.31 ± 5.38 (range, 1.5-19.7) years, the underlying disease was mostly neuroblastoma (NBL). The body weight of 21 patients (43.75%) was 15 kg or less. The targeted autologous peripheral stem cell apheresis (APSCA) was successfully achieved in 98% of patients. Neuroblastoma patients were younger than the rest of the patients and underwent apheresis after receiving fewer chemotherapy cycles than others and all of them mobilized within the first session successfully. Plerixafor was added to mobilization in nine heavily pretreated patients (18.7%), median two doses (range, 1-4 doses). 11 patients (22.9%) underwent radiotherapy (RT) before mobilization with doses of median 24 Gy (range, 10.8-54.0 Gy). Patients with RT were older at the time of apheresis and had received more chemotherapy courses than patients without RT. As a result, patients with a history of RT had significantly lower peripheral CD34+ cells and CD34+ yields than those without RT. In 17 patients (35.4%), 22 different complications were noted. The most common complications were catheter-related infections (n:10, 20.8%), followed by catheter-related thrombosis in eight patients (16.7%).
CONCLUSIONS: Patients who had far less therapy before apheresis were more likely to mobilize successfully. Our study provides a detailed practice approach including complications during APSCA aiming to increase the success rates of apheresis in transplantation centers.
方法:回顾性分析2011年1月至2020年4月接受自体干细胞动员和单采术的儿科患者的资料。
结果:我们回顾性研究了48例儿科患者(34例男性,14名女性),平均年龄7.31±5.38(范围,1.5-19.7)年,基础疾病主要是神经母细胞瘤(NBL).21例患者(43.75%)的体重为15kg或以下。98%的患者成功实现了靶向自体外周干细胞单采(APSCA)。神经母细胞瘤患者比其他患者年轻,并且在接受比其他患者更少的化疗周期后接受了单采手术,并且所有患者都在第一次会议内成功动员。在9名严重预处理的患者(18.7%)中,将Plerixafor添加到动员中,中位数两个剂量(范围,1-4剂)。11例患者(22.9%)在动员前接受放疗(RT),中位剂量为24Gy(范围,10.8-54.0Gy)。与没有RT的患者相比,接受RT的患者在进行单采时年龄更大,并且接受了更多的化疗疗程。因此,有RT病史的患者的外周CD34+细胞和CD34+产量显著低于无RT病史的患者.17例患者(35.4%),共有22种不同的并发症。最常见的并发症是导管相关性感染(n:10,20.8%),其次是导管相关血栓形成8例(16.7%).
结论:在单采之前接受少得多治疗的患者更有可能成功动员。我们的研究提供了详细的实践方法,包括APSCA期间的并发症,旨在提高移植中心的单采成功率。