COLLECTION AND TRANSPLANTATION OF PERIPHERAL-BLOOD PROGENITOR CELLS MOBILIZED BY G-CSF ALONE IN CHILDREN WITH MALIGNANCIES

Results of collection and transplantation of peripheral blood progenit or cells (PBPC) mobilized by G-CSF in 31 children with different malig nancies were analysed. A total of 43 aphereses were performed, followi ng administration of granulocyte colony-stimulating factor (G-CSF), us ing a continuous flow blood cell separator (Cobe Spectra) through a ce ntral venous catheter. For patients weighing less than or equal to 25 kg the extracorporeal line was primed with red blood cells, The mean b lood flow rate was 33 . 2 ml/min (range 12-56 ml/min), The mean number of mononuclear cells (MNC), granulocyte-macrophage colony-forming uni ts (CFU-GM) and CD34(+) cells collected were 7 . 22 x 10(8)/kg body we ight (b.w.), 15 . 9 x 10(4)/kg and 5 . 44 x 10(6)/kg respectively. The morbidity related to PBPC collection was low and the mean apheresis t ime was 302 . 7 min (range 115-492). The volume of processed blood for apheresis (per kilogram body weight) ranged from 117 to 539 . 6 (mean 309 . 13 ml/kg). 20 patients required only one apheresis to collect t he minimum requirement of 5-7 x 10(8)/kg of MNC. All patients subseque ntly underwent autografting with PBPC after myeloablative therapy. Day s to achieve an absolute count of neutrophils (ANC) > 0 . 5 x 10(9)/l and a platelet count of 20 x 10(9)/l without platelet support were 9 . 5 and 18, respectively. The number of CD34(+) cells infused correlate d highly with engraftment kinetics. The extra-medullary toxicity was l ow and manageable.