Procedure‐related complications and adverse events associated with pediatric autologous peripheral blood stem cell collection

Abstract

Venous access and flow-related issues are a major factor associated with moderate and severe AE, effecting ∼10% of patients. AE are more frequent with increasing patient age, weight, and number of procedures. J. Clin. Apheresis 32:35-48, 2017. © 2016 Wiley Periodicals, Inc.

Comparison of two apheresis systems for autologous stem cell collections in pediatric oncology patients

“…[1][2][3][4][5] The initial part of the ASCT process requires collection of stem cells, which can be challenging in the pediatric population, especially for low-weight patients such as babies and toddlers, who are more prone to hemodynamic influences of fluid shifts due to the circulating blood volumes and to the exposure to anticoagulants and who may have more difficulty with the prolonged duration of the collection procedure. [6][7][8] Our medical center performs approximately 50 ASCTs per year for pediatric patients. In February 2015 our institution introduced the novel Spectra Optia MNC (Optia) apheresis device for the collection of mobilized peripheral stem cells, which has eventually replaced the former COBE Spectra (COBE) device (both from TerumoBCT).…”

Performance and safety of femoral central venous catheters in pediatric autologous peripheral blood stem cell collection

“…with flow‐related issues in 3–64% of patients (Table ). This is particularly true of left subclavian CVCs, which have a 16–50% AE rate during A‐HPCC and account for 19% of severe procedure‐related AE at our institution . The increased length associated with left subclavian lines inherently increases resistance to flow and the potential for anatomic obstruction .…”

“…This was significantly better than the AE rate in 19 pediatric patients with thoracic CVC (42%, P = 0.001). Pediatric patients with thoracic CVCs had a significantly higher rate of flow‐related AE and were more likely to have prolonged procedures due to a slow inlet rate (<0.7 mL min −1 kg −1 ), require alternate venous access, and in two patients, early termination of the procedure (Table ) . Finally, there were no confirmed cases of bacterial contamination using femoral CVC in the last 10‐years whereas a tunneled thoracic CVC was linked to line‐associated bacterial contamination of two products.…”

“…This is particularly true of left subclavian CVCs, which have a 16-50% AE rate during A-HPCC and account for 19% of severe procedure-related AE at our institution. 15,38,[57][58][59][60] The increased length associated with left subclavian lines inherently increases resistance to flow and the potential for anatomic obstruction. 57 The distal tip can either adhere along the lateral superior vena cava with intermittent occlusion, or reflect back into the left brachial cephalic vein with intravascular knotting.…”

A Method to Predict the Yield of Peripheral Blood Stem Cells Collected by Large Volume Leukapheresis

“…Thus, it would be convenient for both the donors and the transplantation coordinating facilities to know when the collection can be completed so they can arrange transportation, etc. Moreover, although PBSC collection is generally a safe, well tolerated procedure [10], procedure related adverse events still occurs [11] and the length of PBSC collection has been associated with more adverse events and bad donation experience [12,13]. Therefore, it is desirable to have a reliable prediction method in order to avoid unnecessarily prolonged collection for the safety of donors.…”