Öz
Amaç: Hematopoetik kök hücre kaynağı olarak periferik kan kök hücreleri hem malign hem de non-malign hastalıklarda giderek daha çok kullanılmaktadır. Ancak çocuklarda özellikle de küçük çocuklarda erişkinlerden farklı olarak periferik kan kök hücre toplanmasında damar yolu ve ekstrakorporeal set volümü gibi zorluklarla karşılaşılabilmektedir.
Yöntem: Biz bu çalışmada Kasım 2016 ile Eylül 2023 tarihleri arasında, kendi merkezimizde periferik kan kök hücre toplaması ve transplantasyonu yaptığımız 63 çocuk hastayı sunuyoruz.
Bulgular: Aferez seansları sırasında çocukların ortalama yaş ve kiloları sırasıyla 10.25 ve 34 kg idi. Toplam 63 periferik kan kök hücre toplanması ve transplantasyonu işleminin 48’i otolog, 15’i allojeneik idi. Her aferez seansında elde edilen ortalama kök hücre sayısı 2.6 x 106 CD34+ hücre/kg (0.6-9.66) idi. Toplam 63 hasta ve donordan 4’üne multipl aferez seansları gerekti. Aferez seansları sonrası önemli bir yan etki gözlenmedi.
Sonuç: Deneyimli ellerde, çocuklarda periferik kan kök hücre toplaması ve transplantasyonunun en az erişkinler kadar güvenli ve etkili olduğunu gözlemledik.
Anahtar Kelimeler
kemik iliği nakli hematopoetik kök hücre nakli periferik kök hücre nakli çocuklar
Kaynakça
- Yeşilipek MA. Hematopoetic stem cell transplantation in children. Turk Pediatri Ars 2014 Jun;49(2)91-8.
- Foeken LM, Green A, Hurley CK, Marry E, Wiegand T, Oudshoorn M. Monitoring the international use of unrelated donors for transplantation: the WMDA annual reports. Bone Marrow Transplant 2010 May;45(5):811-8.
- Watanabe T, Takaue Y, Kawano Y, Koike K, Kikuta A, Imaizumi M, et al. HLA-identical sibling peripheral blood stem cell transplantation in children and adolescents. Biol Blood Marrow Transplant 2002;8(1):26-31.
- Benito AI, Gonzalez-Vicent M, Garcia F, Balas A, Quintero V, Madero L, et al. Allogeneic peripheral blood stem cell transplantation (PBSCT) from HLA-identical sibling donors in children with hematological diseases: a single center pilot study. Bone Marrow Transplant 2001 Sep;28(6):537-43.
- Yesilipek MA, Hazar V, Küpesiz A, Kizilörs A, Uguz A, Yegin O. Peripheral blood stem cell transplantation in children with beta-thalassemia. Bone Marrow Transplant 2001 Dec;28(11):1037-40.
- Anderlini P, Rizzo JD, Nugent ML, Schmitz N, Champlin RE, Horowitz MM. Peripheral blood stem cell donation: an analysis from the International Bone Marrow Transplant Registry (IBMTR) and European Group for Blood and Marrow Transplant (EBMT) databases. Bone Marrow Transplant 2001 Apr;27(7):689-92.
- Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, et al. Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. Bone Marrow Transplant 2015 Apr;50(4):476-82.
- Styczynski J, Balduzzi A, Gil L, Labopin M, Hamladji RM, Marktel S, et al. Risk of complications during hematopoietic stem cell collection in pediatric sibling donors: a prospective European Group for Blood and Marrow Transplantation Pediatric Diseases Working Party study. Blood 2012 Mar 22;119(12):2935-42.
- Miano M, Labopin M, Hartmann O, Angelucci E, Cornish J, Gluckman E, et al. Haematopoietic stem cell transplantation trends in children over the last three decades: a survey by the paediatric diseases working party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2007 Jan;39(2):89-99.
- Deméocq F, Kanold J, Chassagne J, Bezou MJ, Lutz P, deLumley L, et al. Successful blood stem cell collection and transplant in children weighing less than 25 kg. Bone Marrow Transplant 1994 Jan;13(1):43-50.
- Nussbaumer W, Schönitzer D, Trieb T, Fink FM, Maurer-Dengg K, Höcker P, et al. Peripheral blood stem cell (PBSC) collection in extremely low-weight infants. Bone Marrow Transplant 1996 Jul;18(1):15-7.
- Shimosato Y, Tanoshima R, Tsujimoto SI, Takeuchi M, Shiba N, Kobayashi T, et al. Allogeneic Bone Marrow Transplantation versus Peripheral Blood Stem Cell Transplantation for Hematologic Malignancies in Children: A Systematic Review and Meta-Analysis. Biol Blood Marrow Transplant 2020 Jan;26(1):88-93.
- Lipton JM. Peripheral blood as a stem cell source for hematopoietic cell transplantation in children: is the effort in vein? Pediatr Transplant 2003:7 Suppl 3:65-70.
- Meisel R, Klingebiel T, Dilloo D. Peripheral blood stem cells versus bone marrow in pediatric unrelated donor stem cell transplantation. Blood 2013 Jan 31;121(5):863-5.
- Styczynski J, Labopin M, Elarouci N, Balduzzi A, Gil L, Ehlert K, et al. Pediatric Sibling Donor Complications of Hematopoietic Stem Cell Collection: EBMT Pediatric Diseases Working Party Study. Blood 2009 Nov 20;114(22); Abstract 806.
- Pulsipher MA, Levine JE, Hayashi RJ, Chan KW, Anderson P, Duerst R, et al. Safety and efficacy of allogeneic PBSC collection in normal pediatric donors: the pediatric blood and marrow transplant consortium experience (PBMTC) 1996-2003. Bone Marrow Transplant 2005 Feb;35(4):361-7.
- Pulsipher MA, Nagler A, Iannone R, Nelson RM. Weighing the risks of G-CSF administration, leukopheresis, and standard marrow harvest: ethical and safety considerations for normal pediatric hematopoietic cell donors. Pediatr Blood Cancer 2006 Apr;46(4):422-33.
- Majolino I, Aversa F, Bacigalupo A, Bandini G, Arcese W, Reali G. Allogeneic transplants of rhG-CSF-mobilized peripheral blood stem cells (PBSC) from normal donors. GITMO. Gruppo Italiano Trapianto di Midollo Osseo. Haematologica 1995 Jan-Feb;80(1):40-3.
- Giralt S, Costa L, Schriber J, Dipersio J, Maziarz R, McCarty J, et al. Optimizing autologous stem cell mobilization strategies to improve patient outcomes: consensus guidelines and recommendations. Biol Blood Marrow Transplant 2014 Mar;20(3):295-308.
- Duong HK, Savani BN, Copelan E, Devine S, Costa LJ, Wingard JR, et al. Peripheral blood progenitor cell mobilization for autologous and allogeneic hematopoietic cell transplantation: guidelines from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2014 Sep;20(9):1262-73.
- Sevilla J, González-Vicent M, Madero L, García-Sánchez F, Díaz MA. Granulocyte colony-stimulating factor alone at 12 microg/kg twice a day for 4 days for peripheral blood progenitor cell priming in pediatric patients. Bone Marrow Transplant 2002 Oct;30(7):417-20.
- Flomenberg N, Devine SM, Dipersio JF, Liesveld JL, McCarty JM, Rowley SD, et al. The use of AMD3100 plus G-CSF for autologous hematopoietic progenitor cell mobilization is superior to G-CSF alone. Blood 2005 Sep 1;106(5):1867-74.
- Diaz MA, Vicent MG, Garcia-Sanchez F, Vicario JL, Madero L. Long-term hematopoietic engraftment after autologous peripheral blood progenitor cell transplantation in pediatric patients: effect of the CD34+ cell dose. Vox Sang 2000;79(3):145-50.
- Bensinger W, Appelbaum F, Rowley S, Storb R, Sanders J, Lilleby K, et al. Factors that influence collection and engraftment of autologous peripheral-blood stem cells. J Clin Oncol 1995 Oct;13(10):2547-55.
- Orbach D, Hojjat-Assari S, Doz F, Pacquement H, Guillaume A, Mathiot C, et al. Peripheral blood stem cell collection in 24 low-weight infants: experience of a single centre. Bone Marrow Transplant 2003 Feb;31(3):171-4.
- Patiroglu T, Ozdemir MA, Unal E, Altuner Torun Y, Coskun A, Menku A, et al. Intracranial hemorrhage in children with congenital factor deficiencies. Childs Nerv Syst 2011 Nov;27(11):1963-6.
- Karakukcu M, Unal E. Stem cell mobilization and collection from pediatric patients and healthy children. Transfus Apher Sci 2015 Aug;53(1):17-22.
- Sevilla J, Díaz MA, Fernández-Plaza S, González-Vicent M, Madero L. Risks and methods for peripheral blood progenitor cell collection in small children. Transfus Apher Sci 2004 Dec;31(3):221-31.
Collection and Transplantation of Peripheral Blood Stem Cells in Children: A Single-Center Experience
Öz
Background/Aims: As a source of hematopoietic stem cells, peripheral blood stem cells have been used more frequently in both malignant and non-malignant diseases. There are some difficulties in the collection of PBSC from children compared to adults such as vascular access and, extracorporeal circuit volume, especially in small children.
Methods: In this study, we present our experience in 63 children who underwent peripheral blood stem cell collection and transplantation between November 2016 and September 2023.
Results: The median age and weight of the children at the time of apheresis procedures were 10.25 years and 34 kg, respectively. Of 63 peripheral blood stem cell collection and transplantations, 48 were autologous and 15 were allogeneic. The median cell yield per apheresis procedure was 2.6 x 106 CD34+ cells/kg (0.6-9.66). Four of the total 63 patients and donors required multiple apheresis procedures. No significant side effects were observed after apheresis procedures.
Conclusions: We observed that in experienced hands, peripheral blood stem cell collection and transplantation in children is at least as safe and effective as in adults.
Anahtar Kelimeler
bone marrow transplantation hematopoietic stem cell transplantation peripheral stem cell transplantation children
Kaynakça
- Yeşilipek MA. Hematopoetic stem cell transplantation in children. Turk Pediatri Ars 2014 Jun;49(2)91-8.
- Foeken LM, Green A, Hurley CK, Marry E, Wiegand T, Oudshoorn M. Monitoring the international use of unrelated donors for transplantation: the WMDA annual reports. Bone Marrow Transplant 2010 May;45(5):811-8.
- Watanabe T, Takaue Y, Kawano Y, Koike K, Kikuta A, Imaizumi M, et al. HLA-identical sibling peripheral blood stem cell transplantation in children and adolescents. Biol Blood Marrow Transplant 2002;8(1):26-31.
- Benito AI, Gonzalez-Vicent M, Garcia F, Balas A, Quintero V, Madero L, et al. Allogeneic peripheral blood stem cell transplantation (PBSCT) from HLA-identical sibling donors in children with hematological diseases: a single center pilot study. Bone Marrow Transplant 2001 Sep;28(6):537-43.
- Yesilipek MA, Hazar V, Küpesiz A, Kizilörs A, Uguz A, Yegin O. Peripheral blood stem cell transplantation in children with beta-thalassemia. Bone Marrow Transplant 2001 Dec;28(11):1037-40.
- Anderlini P, Rizzo JD, Nugent ML, Schmitz N, Champlin RE, Horowitz MM. Peripheral blood stem cell donation: an analysis from the International Bone Marrow Transplant Registry (IBMTR) and European Group for Blood and Marrow Transplant (EBMT) databases. Bone Marrow Transplant 2001 Apr;27(7):689-92.
- Passweg JR, Baldomero H, Bader P, Bonini C, Cesaro S, Dreger P, et al. Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. Bone Marrow Transplant 2015 Apr;50(4):476-82.
- Styczynski J, Balduzzi A, Gil L, Labopin M, Hamladji RM, Marktel S, et al. Risk of complications during hematopoietic stem cell collection in pediatric sibling donors: a prospective European Group for Blood and Marrow Transplantation Pediatric Diseases Working Party study. Blood 2012 Mar 22;119(12):2935-42.
- Miano M, Labopin M, Hartmann O, Angelucci E, Cornish J, Gluckman E, et al. Haematopoietic stem cell transplantation trends in children over the last three decades: a survey by the paediatric diseases working party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2007 Jan;39(2):89-99.
- Deméocq F, Kanold J, Chassagne J, Bezou MJ, Lutz P, deLumley L, et al. Successful blood stem cell collection and transplant in children weighing less than 25 kg. Bone Marrow Transplant 1994 Jan;13(1):43-50.
- Nussbaumer W, Schönitzer D, Trieb T, Fink FM, Maurer-Dengg K, Höcker P, et al. Peripheral blood stem cell (PBSC) collection in extremely low-weight infants. Bone Marrow Transplant 1996 Jul;18(1):15-7.
- Shimosato Y, Tanoshima R, Tsujimoto SI, Takeuchi M, Shiba N, Kobayashi T, et al. Allogeneic Bone Marrow Transplantation versus Peripheral Blood Stem Cell Transplantation for Hematologic Malignancies in Children: A Systematic Review and Meta-Analysis. Biol Blood Marrow Transplant 2020 Jan;26(1):88-93.
- Lipton JM. Peripheral blood as a stem cell source for hematopoietic cell transplantation in children: is the effort in vein? Pediatr Transplant 2003:7 Suppl 3:65-70.
- Meisel R, Klingebiel T, Dilloo D. Peripheral blood stem cells versus bone marrow in pediatric unrelated donor stem cell transplantation. Blood 2013 Jan 31;121(5):863-5.
- Styczynski J, Labopin M, Elarouci N, Balduzzi A, Gil L, Ehlert K, et al. Pediatric Sibling Donor Complications of Hematopoietic Stem Cell Collection: EBMT Pediatric Diseases Working Party Study. Blood 2009 Nov 20;114(22); Abstract 806.
- Pulsipher MA, Levine JE, Hayashi RJ, Chan KW, Anderson P, Duerst R, et al. Safety and efficacy of allogeneic PBSC collection in normal pediatric donors: the pediatric blood and marrow transplant consortium experience (PBMTC) 1996-2003. Bone Marrow Transplant 2005 Feb;35(4):361-7.
- Pulsipher MA, Nagler A, Iannone R, Nelson RM. Weighing the risks of G-CSF administration, leukopheresis, and standard marrow harvest: ethical and safety considerations for normal pediatric hematopoietic cell donors. Pediatr Blood Cancer 2006 Apr;46(4):422-33.
- Majolino I, Aversa F, Bacigalupo A, Bandini G, Arcese W, Reali G. Allogeneic transplants of rhG-CSF-mobilized peripheral blood stem cells (PBSC) from normal donors. GITMO. Gruppo Italiano Trapianto di Midollo Osseo. Haematologica 1995 Jan-Feb;80(1):40-3.
- Giralt S, Costa L, Schriber J, Dipersio J, Maziarz R, McCarty J, et al. Optimizing autologous stem cell mobilization strategies to improve patient outcomes: consensus guidelines and recommendations. Biol Blood Marrow Transplant 2014 Mar;20(3):295-308.
- Duong HK, Savani BN, Copelan E, Devine S, Costa LJ, Wingard JR, et al. Peripheral blood progenitor cell mobilization for autologous and allogeneic hematopoietic cell transplantation: guidelines from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2014 Sep;20(9):1262-73.
- Sevilla J, González-Vicent M, Madero L, García-Sánchez F, Díaz MA. Granulocyte colony-stimulating factor alone at 12 microg/kg twice a day for 4 days for peripheral blood progenitor cell priming in pediatric patients. Bone Marrow Transplant 2002 Oct;30(7):417-20.
- Flomenberg N, Devine SM, Dipersio JF, Liesveld JL, McCarty JM, Rowley SD, et al. The use of AMD3100 plus G-CSF for autologous hematopoietic progenitor cell mobilization is superior to G-CSF alone. Blood 2005 Sep 1;106(5):1867-74.
- Diaz MA, Vicent MG, Garcia-Sanchez F, Vicario JL, Madero L. Long-term hematopoietic engraftment after autologous peripheral blood progenitor cell transplantation in pediatric patients: effect of the CD34+ cell dose. Vox Sang 2000;79(3):145-50.
- Bensinger W, Appelbaum F, Rowley S, Storb R, Sanders J, Lilleby K, et al. Factors that influence collection and engraftment of autologous peripheral-blood stem cells. J Clin Oncol 1995 Oct;13(10):2547-55.
- Orbach D, Hojjat-Assari S, Doz F, Pacquement H, Guillaume A, Mathiot C, et al. Peripheral blood stem cell collection in 24 low-weight infants: experience of a single centre. Bone Marrow Transplant 2003 Feb;31(3):171-4.
- Patiroglu T, Ozdemir MA, Unal E, Altuner Torun Y, Coskun A, Menku A, et al. Intracranial hemorrhage in children with congenital factor deficiencies. Childs Nerv Syst 2011 Nov;27(11):1963-6.
- Karakukcu M, Unal E. Stem cell mobilization and collection from pediatric patients and healthy children. Transfus Apher Sci 2015 Aug;53(1):17-22.
- Sevilla J, Díaz MA, Fernández-Plaza S, González-Vicent M, Madero L. Risks and methods for peripheral blood progenitor cell collection in small children. Transfus Apher Sci 2004 Dec;31(3):221-31.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 15 Haziran 2024 |
| Yayımlanma Tarihi | 30 Haziran 2024 |
| Gönderilme Tarihi | 4 Kasım 2023 |
| Kabul Tarihi | 1 Nisan 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 34 Sayı: 3 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.