Peripheral Blood Stem Cell Mobilization and Collection in Pediatric Healthy Sibling Donors Weighing 20 Kilograms or Less; Algerian Experience

Benakli, Malek; Nacer, Redhouane Ahmed; Mehdid, Farih; Belhadj, Rachida; Rahmoune, Nadia; Baazizi, Mounira; Ouali, Dina Ait; Harieche, Farida; Hamladji, Rose‐Marie

doi:10.1016/j.transci.2020.102987

Cited by 10 publications

(10 citation statements)

References 28 publications

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“…The most significant challenge in this patient population is obtaining a stable vascular access. Although PBSC apheresis can be successfully performed with peripheral canulae in older children, patients below 2 years of age usually require central venous access 10,11. We used a noncuffed Vygon catheter, which allows a maximum flow rate of 15 mL/minute.…”

Section: Discussionmentioning

confidence: 99%

Considerations for Peripheral Blood Stem Cell Apheresis in a Low Body Weight Infant

Singh¹,

Kakkar

Singh³

et al. 2021

Journal of Pediatric Hematology/Oncology

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Introduction: Peripheral blood stem cell (PBSC) apheresis in infants (< 10 kg body weight) requires specific precautions to prevent periprocedural complications.Case Report: A 9 month old child was diagnosed with high-risk neuroblastoma and planned for autologous stem cell transplantation after induction chemotherapy. We illustrate the precautions and technical details observed while performing PBSC collection in this patient.Discussion: Use of continuous flow devices, priming of apheresis circuits, appropriate flow rates and continuous monitoring can help to mitigate several procedure related complications.Conclusions: PBSC apheresis in infants (< 10 Kg) is safe and feasible with appropriate precautions detailed above.

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Section: Discussionmentioning

confidence: 99%

Considerations for Peripheral Blood Stem Cell Apheresis in a Low Body Weight Infant

Singh¹,

Kakkar

Singh³

et al. 2021

Journal of Pediatric Hematology/Oncology

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“…All patients, with Lansky score ≥90, were transplanted from matched sibling donors with PBSC. Donors (1 brother and 3 sisters) with median age 12 years (11 to 21 y) received granulocyte colony–stimulating factor (filgrastim, Neupogen, 10 µg/kg once daily for 5 d) and collection done on days 5 and 6 using a continuous flow blood cell separator (COBE spectra or Optia, Terumo-BCT) with the mononuclear cell program 15…”

Section: Methodsmentioning

confidence: 99%

“…Donors (1 brother and 3 sisters) with median age 12 years (11 to 21 y) received granulocyte colony-stimulating factor (filgrastim, Neupogen, 10 µg/kg once daily for 5 d) and collection done on days 5 and 6 using a continuous flow blood cell separator (COBE spectra or Optia, Terumo-BCT) with the mononuclear cell program. 15 All patients were isolated during hospitalization in the pretransplantation and immediate posttransplantation period in HEPA filtered room. Antimicrobial prophylaxis with acyclovir, fluconazole, and sulfamethoxazole/trimethoprim was given respectively against viral, fungal, and Pneumocystis jirovecii infections to all patients.…”

mentioning

confidence: 99%

Successful Allogeneic Peripheral Blood Stem Cell Transplantation in 4 Wiskott-Aldrich Syndrome Patients

Benakli¹,

Nacer²,

Mehdid³

et al. 2021

Journal of Pediatric Hematology/Oncology

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Background: Allogeneic hematopoietic stem cell transplantation is a potential curative treatment in Wiskott-Aldrich syndrome (WAS). Here, we analyzed the outcomes in 4 WAS patients who underwent this procedure with peripheral blood stem cell (PBSC) in our center.Patients and Methods: Four patients with severe WAS phenotype have received allogeneic hematopoietic stem cell transplantation between January 2014 and December 2019 from matched sibling donors with PBSC. Two different preparative conditioning regimens were provided: the first associated busulfan-cyclophosphamide (2 patients) and the second with busulfan-fludarabine administered to the others. Cyclosporine gave as preferred graftversus-host disease prophylaxis with a short course of methotrexate.Results: All patients achieved engraftment after PBSC with a median CD34 + cell count: 13.6×10 6 /kg (8 to 24.9×10 6 /kg). Chronic graft-versus-host disease developed in 2 patients treated by cyclosporine-steroids with complete resolution. Chimerism for all the patients was fully donor ( > 95% donor). After a median follow-up of 41 months (8 to 74 mo), all patients (100%) are alive, healthy, with complete clinical, immunologic, and hematologic recovery, without signs of WAS. Conclusion:This limited study with high-dose PBSC transplantation approach for WAS, demonstrated a safe and effective treatment option, with rapid engraftment, without complications, excellent long-term outcomes, independent of conditioning regimen.

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“…However, only one-third of cases succeeded with one apheresis session, while 20% of them needed three apheresis procedures to achieve the desired amount of CD34+ cells [48]. Truong et al described an 11% failure rate (4 out of 35 HDs), and only older age was found significant, although older age correlated with lower CD34 + cell count pre apheresis, being ≥20,000/ml the ideal value [19].…”

Section: How Is Plerixafor Used? Dosing and Administrationmentioning

confidence: 99%

“…The need of a venous central catheter to gain an adequate venous access adds to the inconvenience. In expert hands, about 10% of adult HDs need a central vein catheter, but at least 40% of small children can need a femoral catheter, in some cases for several days [48]. All these problems become more relevant for non-related HDs.…”

Section: Research Initiativesmentioning

confidence: 99%

Use of plerixafor to mobilize haematopoietic progenitor cells in healthy donors

et al. 2021

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Increased transplant activity calls for improved stem cell collection, especially when peripheral blood is the preferred source of haematopoietic progenitor cells (HPCs).Plerixafor is a bicyclam molecule that mobilizes CD34+ cells by reversibly disrupting CXCR4-CXCL12-supported HPC retention. Plerixafor is given with granulocyte colony-stimulating factor (G-CSF) to help harvest autologous CD34+ cells for transplantation when mobilization with G-CSF fails. Mobilization protocols with the same doses of plerixafor and G-CSF have been used off-label in healthy allogeneic donors, with equal success and scarce side effects, both in adult and paediatric patients.Plerixafor has also been used as a sole mobilization agent. Plerixafor alone or coupled with G-CSF might lead to harvesting distinct cellular populations conferring improved engraftment properties and increased survival. Those characteristics might make plerixafor an especially attractive mobilization agent, particularly for non-related donations. However, available data are limited, and long-term follow-up is needed to clarify the best scenario for using plerixafor with or without G-CSF in healthy donors.In this review, we will summarize the evidence supporting this practice, highlighting the practical aspects and providing clues for an expanded use of plerixafor.

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Peripheral Blood Stem Cell Mobilization and Collection in Pediatric Healthy Sibling Donors Weighing 20 Kilograms or Less; Algerian Experience

Cited by 10 publications

References 28 publications

Considerations for Peripheral Blood Stem Cell Apheresis in a Low Body Weight Infant

Considerations for Peripheral Blood Stem Cell Apheresis in a Low Body Weight Infant

Successful Allogeneic Peripheral Blood Stem Cell Transplantation in 4 Wiskott-Aldrich Syndrome Patients

Use of plerixafor to mobilize haematopoietic progenitor cells in healthy donors

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