Allogeneic PBPC transplantation in children

Background While PBPC are being used increasingly as a source of stem cells in allotransplantation, the published experience in pediatric donor-recipi ent pairs is limited. Our aim was to evaluate the mobilization of PBPC in h ealthy child donors and the outcome of child recipients undergoing allogene ic PBSC transplant. Methods Eight children with AML (one), refractory anemia with excess blasts in transformation (RAEBt) (one), ALL (four), NHL (one) and neuroblastoma ( one)] were grafted with PBPC from HLA-identical sibling donors (seven patie nts) or from a 2-antigen mismatched donor (one case). donors, aged 1-15 yea rs underwent leukapheresis after mobilization with G-CSF (10-15 g/kg/day, 4 days). The extracorporeal line was primed in five cases (four with HSA). P eripheral venous access was used in all except one infant. The harvest were cryopreserved in six cases. GvHD prophylaxis consisted of CsA plus MTX or methylprednisolone. Results No adverse effects related to G-CSF administration, nor procedure-r elated complications were observed. Median number of CD34+ cells harvested was 5.18 x 10(6)/kg (range, 2.56-6.40), after one (five cases) or two (thre e cases) leukaphereses. All patients engrafted. The median time to achieve an ANC > 0.5 x 10(9)/L was 11 days (range 9-13) and a platelet count of > 5 0 x 10(9)/L was 18 days (range 13-45). Six patients did not develop any acu te GvHD and three developed chronic GvHD. After a median follow-up of 18 mo nths (14-44 months), six patients are alive and five in complete remission. Discussion Allogeneic PBPC transplantation has shown to be a safe and succe ssful procedure for pediatric donor and recipients pairs.