Peripheral blood stem cell collection and transplantation in paediatric malignancies: a monocentric experience

Thirty-seven patients underwent peripheral blood stem cell (PBSC) collectio n from May 1994 to May 1997, Twenty-five were males and 12 were females, th e median age at collection was 11.5 years (range 1-27.4) and the median wei ght was 38 kg (range 9-80), As mobilising chemotherapy, cyclophosphamide, e toposide, doxorubicin and cytosine arabinoside were the drugs most frequent ly used in association with G-CSF for a total of 47 courses. Sixty-one aphe reses were performed with a median collection of CD34(+) and CFU-GM celIs/k g of 3.6x10(6) (range 0.6-31.8) and 24.4x10(4) (range 0.1-1260), respective ly. Minimal residual disease (MRD) was found in five of the 30 investigated aphereses, Twenty-one of the 37 patients underwent high-dose chemotherapy with autologous stem cell rescue: in seven the stem cell source was periphe ral blood and bone marrow, The median duration of hospitalization was 18 da ys for the PBSC group and 23 days for the PBSC/ABMT group, Overall survival was 78.7% at a median follow-up of 18 months (range 2-31) and the DFS was 52% without difference depending on stem cell source. Compared to a histori cal group of ABMT patients, the PBSC group showed a statistical advantage i n terms of neutrophils and platelet engraftment, blood and platelet require ments, and length of hospitalization. PBSC collection is a feasible procedu re also in the paediatric setting providing that vascular access is adequat e, As already reported, PBSC transplant results in faster engraftment and s horter hospitalization that could allow a better utilization of health fina ncial resources. The question whether the source of stem cells could influe nce transplant outcome would require a prospective randomised study.