ALLOGENEIC PERIPHERAL FLOOD STEM-CELL TRANSPLANT IN CHILDREN

Allogeneic peripheral blood stem cell (PBSC) transplant has recently b een introduced for the treatment of hematological malignancies. As the data were limited mainly to adult patients, this study aimed to asses s the feasibility and safety of this procedure in pediatric patients a nd donors. Eleven children aged 2-16 years received allogeneic PBSC tr ansplant for acute lymphoblastic leukemia (n = 4), acute myeloid leuke mia (n = 1), myelodysplastic syndrome in = 1), severe aplastic anemia (n = 3), and thalassemia (n = 2). Nine donors were human leukocyte ant igen (HLA)-identical siblings and the other two were one antigen misma tched family members. Eight donors were younger than 18 years old (10 months to 17 years). Donors were primed with granulocyte colony-stimul ating factor (G-CSF) at 10-16 mu g/kg for 4-5 days. Aphereses were per formed on 1 or 2 consecutive days, and the patients received a mean of 14.4 x 10(8)/kg nucleated cells, 6.9 x 10(6)/kg CD34 cells, and 6.9 x 10(8)/kg T cells. All patients achieved neutrophil counts of >0.5 x 1 0(9)/l at a median of 16 days. Nine patients achieved platelet counts oi >20 x 10(9)/l at a median of 13 days. Grade II acute graft vs. host disease (GVHD) occurred in only one patient. Chronic GVHD was not obs erved in the seven patients with follow-up of more than 3 months. Eigh t patients remained in continuous complete remission after transplant ranged from 2 to 26 months. Allogeneic PBSC transplant appears safe in pediatric patients and donors, and it seems not to be associated with increase of acute GVHD or chronic GVHD. (C) 1998 Wiley-Liss. Inc.