Using peripheral blood progenitor cells (PBPC) for transplantation in pediatric patients: a state-of-the-art review

This paper Presents a state-of-the-art review of using mobilized-peripheral blood progenitor cells (PBPC) for transplantation in children. Our own dat a and those from Medline searches and meeting reports, are analyzed and pre sented for the different sections that involve transplantation. Recommendat ions concerning the choice of mobilization regimens, venous access, priming of separator extracorporeal line, anticoagulation, and number of CD34(+) c ells to infuse for rapid engraftment are proposed. In the allogeneic settin g, we analyze ethical and safety aspects of pediatric donor mobilization an d collection. Data from the literature suggest that the use of cytokine-mob ilized PBPC for allogeneic transplantation appears to be safe both for pedi atric donors and patients leading a rapid hematopoietic engraftment with a similar incidence of acute graft-versus-host disease (GVHD), The high incid ence of chronic GVHD and its management emerge as the most concerning aspec t in allogeneic PBPC transplantation.